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Ulnocarpal translation in perilunate dislocations
D Song1, S Goodman, L A Gilula
1Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
The Journal of Hand Surgery, European Volume
|May 22, 2009
Summary
This study found that most patients with perilunate dislocations experience significant ulnar translation after surgery. Addressing this ulnar translocation component during initial treatment can improve outcomes for wrist injuries.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Radiology
Background:
- Perilunate dislocation is a severe wrist injury involving disruption of the proximal and distal carpal rows.
- Ulnar translation of the carpus is a common complication that can affect functional outcomes.
- Accurate assessment of ulnar translation is crucial for effective treatment planning.
Purpose of the Study:
- To evaluate the prevalence and severity of ulnar translation in patients with perilunate dislocations following surgical reduction.
- To compare carpal measurements before and after pin removal to assess the impact of fixation.
- To determine if addressing the ulnar translocation component during initial treatment improves outcomes.
Main Methods:
- Retrospective analysis of 25 patients with perilunate dislocations.
- Standardized radiographic measurements of ulnar translation and carpal collapse (Gilula score).
- Comparison of measurements before and after pin removal.
Main Results:
- Average Gilula score for ulnar translation was 54%.
- 80% of patients exhibited ulnar translation (lunate uncovering >50%) post-reduction.
- Measurements of lunate uncovering were significantly higher than normal (P<0.01).
- Patients with addressed ulnar translocation showed significantly improved scores.
- No significant difference in measurements before vs. after pin removal.
Conclusions:
- Ulnar translation is a frequent and significant finding in perilunate dislocations post-surgery.
- Surgical management addressing ulnar translocation component shows promise for improved outcomes.
- Pin removal timing did not significantly alter radiographic measurements of ulnar translation.
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