Treatment of isolated perilunate and lunate dislocations with combined dorsal and volar approach and intraosseous cerclage wire

A unique case of bilateral trans-scaphoid perilunate dislocation with dislocation of lunate into the forearm

“…2,3 This is the first case to report bilateral trans-scaphoid perilunate dislocation with the lunate being dislocated into the forearm volarly on the left side. [5][6][7] In our case, the patient recovered to functional range of motion in both wrists with the scaphoid showing union bilaterally. Also, the movement was pain free and there was no evidence of arthritis.…”

Clinical outcomes following reduction and pinning of lesser arc injuries without repair of the scapholunate interosseous ligament

“…24 Despite good Mayo scores and wrist range of movement they reported high complication rates and poor patient satisfaction. Trumble et al 25 described combined dorsal and volar approach with repair of the SLIL, protected by a looped interosseous cerclage wire, to give better compression across the SL interval compared to K-wires. 25 This study reported good range of movement and grip strength when compared to the contralateral side and no deterioration of the SL gap or angle over time, in keeping with the work of Forli et al 11 Unfortunately outcomes such as pain, instability or the incidence of osteoarthritis were not assessed and their results were equivocal with regard to return to work and function.…”

“…Apart from equivocal results achieved with closed and open methods of treatment, implant failure, and other surgical complications such as flexor tendon adhesions, superficial and deep wound sepsis and arthrofibrosis should be taken into account when considering the open treatment of PLDs. 1,22,[24][25][26] Table II compares this study with several other studies assessing the open treatment of these lesser arc injuries. The results of our study are comparable in most included fields.…”

Complex and Rare Fracture Patterns in Perilunate Dislocations

“…Wrist posture at the time of injury is one of extension, intercarpal supination, and ulnar deviation [12]. The classic Mayfield perilunate dislocation combines transmission of force through carpal ligaments, the lesser arc injury, resulting in ligamentous tear and dislocation [7,11,20,21]. In some cases, force transmission travels through the scaphoid bone, the greater arc injuries, and results in a combined fracture dislocation.…”

“…Treatment of median nerve pathology plays a significant role in the choice of treatment of the underlying perilunate injury. Although closed reduction and conservative treatment/splinting has been described as initial management in some of these situations, surgical correction will ultimately be required to adequately treat these injuries [7,11,12,20,21].…”