Results of Perilunate Dislocations and Perilunate Fracture Dislocations With a Minimum 15-Year Follow-Up

Krief, Élie; Appy-Fedida, Benjamin; Rotari, Vladimir; David, Emmanuel; Mertl, P.; Maes-Clavier, Catherine

doi:10.1016/j.jhsa.2015.07.016

Cited by 50 publications

(52 citation statements)

References 28 publications

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“…The high rate of missed diagnoses has also been reported by other series as well and poor initial imaging has been hypothesized as a contributing factor to the frequency of missed injury. 1,8,17,24 However, neither the patients with a missed injury nor those with median nerve paresthesias fared significantly worse in the present investigation. While the patient with the longest time to surgery in the present cohort (44 days) reported poor functional outcomes, he remained on active duty at 5-year follow-up.…”

Section: Discussioncontrasting

confidence: 77%

“…8,18 As such, this study was unable to detect a correlation between demographics and outcomes with radiographic arthritic changes of the carpus, although the correlation between radiographic evidence of posttraumatic arthritis and functional outcomes may be negligible. 11,16,17 Second, the study has limited power, which inhibits risk stratification, particularly with regard to a delay in diagnosis. However, despite this, the present study reports 43-month follow-up in an amplesized, uniquely high-demand cohort reporting specific outcome measures.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Short-(39-49 months), mid-(8 years), and long-term (13-18 years) outcomes have been reported. 6,7,[13][14][15][16][17] These studies have found that most patients go on to experience a reasonable arc of motion (57-83% as compared with contralateral side) and grip strength (73-87% as compared with contralateral side) at up to 13 years of average follow-up. 6,14,16 However, these series are of limited size (11-25 patients), given the rarity of these injuries and none has evaluated outcomes among athletes or populations with consistently intense daily upper extremity demands.…”

mentioning

confidence: 98%

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Perilunate Dislocations and Perilunate Fracture Dislocations in the U.S. Military

et al. 2017

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Perilunate dislocations and perilunate fracture dislocations (PLDs/PLFDs) are rare and often associated with poor outcomes. Heretofore, these outcomes have not been evaluated in a high-demand military population. The purpose of this study was to evaluate the outcomes in a young, active population after sustaining PLD/PLFD injuries. We retrospectively reviewed the U.S. military service members who underwent surgical treatment for a PLD/PLFD (Current Procedural Terminology codes 25695 and 25685) between June 1, 2010, and June 1, 2014 through the Military Health System Management Analysis and Reporting Tool (M2) database, capturing patients with a minimum 2-year follow-up. Patient characteristics and outcomes were gathered; however, radiographic analysis was not possible. In this study, 40 patients (40 wrists) were included with an average follow-up of 47.8 months. The average age was 28.8 years. Twenty-two injuries (55%) were PLFD and 22 (55%) cases involved the nondominant extremity. On initial presentation, 11 (27.5%) were missed and 50% of patients were presented with acute carpal tunnel syndrome. Range of motion (ROM) was 74% and grip strength was 65% compared with the contralateral wrist; 78% reported pain with activity and only 55% remained on active duty status at final follow-up. Injuries to the nondominant extremity were significantly more likely to experience a good to excellent outcome and regained a more ROM. Patients with ligamentous PLD had less pain at rest and were more likely to return to sport. Worse outcomes can be expected for PLD/PLFD of the dominant extremity, transscaphoid PLFD, greater arc injuries, and those undergoing pinning alone. A high-demand patient may expect worse functional results with a higher degree of limitation postoperatively. The level of evidence is therapeutic IV.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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confidence: 98%

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Perilunate Dislocations and Perilunate Fracture Dislocations in the U.S. Military

et al. 2017

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“…Many studies reported improved outcomes in patients who underwent open reduction and internal fixation (ORIF) compared to those treated with closed methods [4,28,35,[45][46][47]. Many different open approaches to TSPLFD have been described, but there is still some debate regarding the surgical exposure [28,38,48,49].…”

Section: Treatmentmentioning

confidence: 99%

Trans-scaphoid Perilunate Fracture Dislocation

Kim¹,

Oh²,

Koh³

et al. 2021

Arch Hand Microsurg

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Trans-scaphoid perilunate fracture dislocations, which account for more than half of total cases of perilunate injuries, are common in young patients and occur as a result of high-energy injuries, and improper management can impair wrist alignment and function. Understanding the related wrist anatomy and pathomechanics may help surgeons evaluate and diagnose patients. Early operation to reduce and fix the injuries should be considered to achieve optimal clinical and radiological outcomes. In this review article, we present an overview of wrist pathoanatomy, the pathomechanics of trans-scaphoid perilunate fracture dislocations, operative treatment options including an arthroscopic procedure, and reported clinical and radiological outcomes.

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“…Higher stage perilunate injuries occur most frequently from high-energy trauma [13]. Lower stage injuries, such as isolated scapholunate or lunotriquetral ligament tears, are more likely to occur in an athlete who collides with another athlete or the ground [11].…”

Section: Diagnosismentioning

confidence: 99%

Scapholunate and perilunate injuries in the athlete

Morrell

Moyer

Quinlan

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of the review Scapholunate and perilunate injuries can be difficult to diagnose and treat in the athlete. In this review article, we present the mechanism of injury, evaluation, management, and outcomes of treatment for these injuries. Recent findings Acute repair of dynamic scapholunate ligament injuries remains the gold standard, but judicious use of a wrist splint can be considered for the elite athlete who is in season. The treatment of static scapholunate ligament injury remains controversial. Newer SL reconstructive techniques that aim to restore scapholunate function without compromising wrist mobility as much as tenodesis procedures show promise in athlete patients. Summary Acute injuries to the scapholunate ligament are best treated aggressively in order to prevent the sequelae of wrist arthritis associated with long-standing ligamentous injury. Acute repair is favored. Reconstructive surgical procedures to manage chronic scapholunate injury remain inferior to acute repair. The treatment of lunotriquetral ligament injuries is not well defined.

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Results of Perilunate Dislocations and Perilunate Fracture Dislocations With a Minimum 15-Year Follow-Up

Cited by 50 publications

References 28 publications

Perilunate Dislocations and Perilunate Fracture Dislocations in the U.S. Military

Perilunate Dislocations and Perilunate Fracture Dislocations in the U.S. Military

Trans-scaphoid Perilunate Fracture Dislocation

Scapholunate and perilunate injuries in the athlete

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