Vergleich der funktionellen Resultate mit MRT-Befunden nach operativer Versorgung von transskaphoidalen perilunären Luxationsfrakturen: Die Rolle von skapholunären Bandläsionen

Strobel, Ulla; Tami, I.; Andreisek, Gustav; Giovanoli, Pietro; Calcagni, Maurizio

doi:10.1055/s-0034-1370993

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Die intravenöse Kontrastmittelgabe ist die "Conditio sine qua non" im Nachweis und Staging von karpalen Osteonekrosen. Während in den frühen Jahren der MRT-Anwendung versucht wurde, den durchblutungsgestörten, in T1-Gewichtung signalkompromittierten Knochen anhand der Signalhöhe in T2-gewichteten Sequenzen in vitale und avitale Bezirke zu differenzieren, gilt es heute anhand intraoperativer Vergleichsstudien als gesichert, dass am Skaphoid die topografische Zuordnung in nekrotische Areale (fehlendes Enhancement), reparative Areale (Hyperenhancement) und normalen Knochen (normales Enhancement) nur anhand T1-gewichteter Sequenzen mit Fettsaturation nach intravenöser KontrastDer Einladung der Herausgeber der Handchirurgie Mikrochirurgie Plastische Chirurgie einen Kommentar zur Publikation der Autoren Strobel et al [1] zu verfassen, komme ich gerne mit folgenden Anmerkungen nach. Das Lig.…”

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Kommentar zu: Strobel U, Tami I, Andreisek G, et al. Vergleich der funktionellen Resultate mit MRT-Befunden nach operativer Versorgung von transskaphoidalen perilunären Luxationsfrakturen: Die Rolle von skapholunären Bandläsionen

Schmitt

2014

Handchir Mikrochir plast Chir

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Kommentar zu: Strobel U, Tami I, Andreisek G, et al. Vergleich der funktionellen Resultate mit MRT-Befunden nach operativer Versorgung von transskaphoidalen perilunären Luxationsfrakturen: Die Rolle von skapholunären Bandläsionen

Schmitt

2014

Handchir Mikrochir plast Chir

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Die skapholunäre Bandverletzung

et al. 2014

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Injuries to the scapholunate ligament are the most frequent cause of carpal instability. Therefore, if a scapholunate lesion is not diagnosed, it may result in a severe dysfunction of the wrist. This review describes the anatomy, and the kinematics of the wrist with an intact as well as a disrupted scapholunate ligament. The diagnostic of an isolated ligament lesion and a ligament injury associated with a fracture of the distal radius is presented. Finally, an algorithm for treatment based on the stage of injury is proposed.

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Pain, impaired functioning, poor satisfaction and diminished health status eight years following perilunate (fracture) dislocations

Lameijer

Niezen

Moumni

et al. 2018

Disability and Rehabilitation

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Purpose: Perilunate (fracture) dislocations are rare injuries and diminished functional outcomes are reported. However, Patient Reported Outcomes (PROs) following these injuries are rarely described. The aim of this study was to investigate the long-term impact of perilunate (fracture) dislocations using a range of measures, including pain, function, and quality of life. Materials and Methods: This cross-sectional study was conducted from January 2016 until March 2016. Eleven patients who had suffered from perilunate (fracture) dislocations between August 1996 and January 2014 were matched on age and gender with 22 healthy controls. Functional outcome included range of motion and grip strength measurements. The Patient Reported Outcomes included: Patient Reported Wrist Evaluation, Disability of Arm, Shoulder and Hand questionnaire, Michigan Hand Questionnaire and the Short Form-36. Results: The 11 patients that were included (9 males) had a median age at injury of 38 years (IQR 33; 54) and median follow up of 97 months (IQR 84-193). Flexion/extension (mean difference À60 , 95% CI À76, À43, p < 0.001) and ulnar/radial deviation (mean difference À28 , 95% CI À38, À18, p < 0.001) were significantly diminished in patients following perilunate (fracture) dislocations. Grip strength was not affected. The patients experienced significantly more pain as assessed on all pain subscales. Physical functioning was significantly worse in the group with perilunate (fracture) dislocations as assessed on all function subscales, except the PRWE function score and the subscale physical functioning of the Short Form-36. Satisfaction as measured with the Michigan Hand Questionnaire satisfaction subscale (mean difference À36, 95% CI À57, À16, p ¼ 0.002) was also reported poorer. No difference was found regarding work participation. Conclusions: A perilunate (fracture) dislocation has a significant impact on everyday life, as patients experience diminished range of motion, pain, diminished physical functioning, diminished satisfaction and report lower general health status than healthy controls. However, no consequences for work participation were found in this study. Level of evidence 3. ä IMPLICATIONS FOR REHABILITATION Flexion/extension and ulnar/radial deviation remains limited following perilunate (fracture) dislocations. Grip strength is not diminished in patients with perilunate (fracture) dislocations. Pain, restrictions in physical functioning, diminished satisfaction and lower general health status are likely to be present following perilunate (fracture) dislocations. If conservative treatment including pain medication and rehabilitation strategies do not relief pain following perilunate (fracture) dislocations, surgical treatment options such as wrist denervation or arthrodesis should be considered.

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Vergleich der funktionellen Resultate mit MRT-Befunden nach operativer Versorgung von transskaphoidalen perilunären Luxationsfrakturen: Die Rolle von skapholunären Bandläsionen

Abstract: MRI findings, as well as X-ray findings, do not correlate with the subjective and objective functional outcomes after surgical treatment of transscaphoid perilunate fracture dislocations. It can be assumed that SL ligament lesions seen in MRI play a major role over the long term course.

Cited by 3 publications

References 18 publications

Kommentar zu: Strobel U, Tami I, Andreisek G, et al. Vergleich der funktionellen Resultate mit MRT-Befunden nach operativer Versorgung von transskaphoidalen perilunären Luxationsfrakturen: Die Rolle von skapholunären Bandläsionen

Kommentar zu: Strobel U, Tami I, Andreisek G, et al. Vergleich der funktionellen Resultate mit MRT-Befunden nach operativer Versorgung von transskaphoidalen perilunären Luxationsfrakturen: Die Rolle von skapholunären Bandläsionen

Die skapholunäre Bandverletzung

Pain, impaired functioning, poor satisfaction and diminished health status eight years following perilunate (fracture) dislocations

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