Trans-Scaphoid Perilunate Fracture Dislocations: Results of Screw Fixation of the Scaphoid and Lunotriquetral Repair With a Dorsal Approach

Knoll, Victoria D.; Allan, Christopher H.; Trumble, Thomas E.

doi:10.1016/j.jhsa.2005.07.007

Cited by 98 publications

(82 citation statements)

References 21 publications

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“…11,18,20 Primary repair of the lunotriquetral ligament has been reported, but it was never repaired in this series. 12,18,20 Only 55% of the study subjects treated for a PLD had suture of the scapholunate ligament. Currently, we repair the scapholunate ligament and protect the repair with K-wires.…”

Section: Discussionmentioning

confidence: 99%

Perilunate Dislocations and Transscaphoid Perilunate Fracture–Dislocations: A Retrospective Study With Minimum Ten-Year Follow-Up

Forli

Courvoisier

Wimsey

et al. 2010

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Perilunate Dislocations and Transscaphoid Perilunate Fracture–Dislocations: A Retrospective Study With Minimum Ten-Year Follow-Up

Forli

Courvoisier

Wimsey

et al. 2010

The Journal of Hand Surgery

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“…21 At more than 3-year follow-up (average, 44 months; range, 25e79 months) there was no LT diastasis and no VISI deformity, with 92% of patients returning to their pre-injury occupation.…”

Section: The Evidence Surgical Approachmentioning

confidence: 90%

Perilunate Dislocations

Vitale¹,

Seetharaman²,

Ruchelsman³

2015

The Journal of Hand Surgery

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A 37-year-old man injured his right wrist in a motor vehicle collision. In the emergency department he had severe wrist pain and median nerve paresthesia. Wrist radiographs identified a dorsal perilunate dislocation (PLD) with the carpus dislocated dorsally and the lunate tilted volar but still located in the lunate fossa. Post-reduction computed tomography scan confirmed no fractures. THE QUESTIONSWhat is the optimal surgical approach for this patient with a purely ligamentous (i.e., "lesser arc" 1 ) dorsal PLD? What bones should be immobilized and what is the best method of internal fixation? CURRENT OPINIONPLDs are high-energy carpal injuries that result in wrist stiffness and arthrosis even if good carpal alignment is restored. 2e7 PLD merits urgent reduction when there is associated median nerve dysfunction, CME INFORMATION AND DISCLOSURESThe Review Section of JHS will contain at least 2 clinically relevant articles selected by the editor to be offered for CME in each issue. For CME credit, the participant must read the articles in print or online and correctly answer all related questions through an online examination. The questions on the test are designed to make the reader think and will occasionally require the reader to go back and scrutinize the article for details.The JHS CME Activity fee of $15.00 includes the exam questions/answers only and does not include access to the JHS articles referenced.

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“…Several methods of open reduction and internal fixation have been proposed in the literature. Many authors have suggested a dorsal approach for its benefit of offering adequate exposure of the proximal carpal row and mid-carpal joint [6,11,16]. The volar approach suggested by Herbert and Fisher [9] allows access to distal scaphoid fractures and allows repair of the volar ligaments and capsular rent as well as the release of the carpal tunnel.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Dorsal Perilunate Dislocations and Fracture–Dislocations Using a Standardized Protocol

Capo¹,

Corti

Shamian

et al. 2012

Hand (New York, N,Y.)

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Background The aims of this study were to evaluate the associated injuries occurring with acute perilunate instability and to assess the clinical and radiographic outcomes of perilunate dislocations and fracture-dislocations treated with a combined dorsal and volar approach. Methods A total of 45 patients (46 wrist injuries) with perilunate dislocations and fracture-dislocations were prospectively evaluated. The size of the mid-carpal ligament tear, the location of the scapholunate ligament tear, and the presence of osteochondral fragments and of the dorsal radiocarpal ligament avulsions were recorded at injury. Final clinical and radiographic outcomes were evaluated in 25 cases (25 wrists) with a minimum of 6 months of follow-up. Results Intraoperative examination of the 46 cases with operative treatment showed the volar carpal ligament tear to be present 100 % of the time and to be an average length of 3.4 cm. Complete avulsion of the dorsal extrinsic radiocarpal ligaments was found in 65.2 % of cases. The scapholunate ligament was torn in 35 cases. Osteochondral fragments were found either volarly or dorsally in 74 % of the cases. The average flexion-extension arc was 82°, forearm rotation was 155°, and grip strength averaged 59 % of the uninjured hand. The average final scapholunate angle was 55°and the scapholunate gap was 2.2 mm. Conclusion Treatment of perilunate fracture-dislocations with a combined volar and dorsal approach results in reasonable and functional clinical results. The incidence of associated injuries with these carpal dislocations is high. Although the perilunate fracture-dislocations have a slightly better radiologic alignment than the dislocation group, the clinical outcome is similar.

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Trans-Scaphoid Perilunate Fracture Dislocations: Results of Screw Fixation of the Scaphoid and Lunotriquetral Repair With a Dorsal Approach

Cited by 98 publications

References 21 publications

Perilunate Dislocations and Transscaphoid Perilunate Fracture–Dislocations: A Retrospective Study With Minimum Ten-Year Follow-Up

Perilunate Dislocations and Transscaphoid Perilunate Fracture–Dislocations: A Retrospective Study With Minimum Ten-Year Follow-Up

Perilunate Dislocations

Treatment of Dorsal Perilunate Dislocations and Fracture–Dislocations Using a Standardized Protocol

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