Patient-Reported Outcomes Following Surgically Managed Perilunate Dislocation: Outcomes After Perilunate Dislocation.

Area of Science:

• Orthopedic Surgery
• Traumatology
• Rehabilitation Medicine

Background:

• Perilunate dislocations (PLDs) are rare, high-energy wrist injuries with potential for significant long-term disability.
• Optimal management and reliable outcome assessment tools for PLDs remain areas of interest.

Purpose of the Study:

• To report midterm clinical outcomes following surgical intervention for perilunate dislocations.
• To evaluate the validity and internal consistency of the Patient-Rated Wrist Evaluation (PRWE) score as an outcome measure.

Main Methods:

• Prospective study of 16 patients undergoing surgical repair for perilunate injuries.
• Surgical management included fracture fixation and ligamentous reconstruction.
• Patients completed the Disabilities of the Arm, Shoulder and Hand (DASH) and PRWE questionnaires, alongside other outcome measures.

Main Results:

• At 24 months, mean grip strength was 59% of the uninjured side; mean flexion/extension were 71%/58%.
• 88% returned to work within 6 months; 63% returned to sport within 1 year.
• The PRWE (36.2) and DASH (25.2) scores showed strong positive correlation (r=+.7), with high internal consistencies (Cronbach's alpha .91 for PRWE, .98 for DASH).

Conclusions:

• Surgical treatment of PLDs can lead to good clinical outcomes and timely return to normal activities.
• The PRWE is a valid and reliable patient-reported outcome measure for severe carpal injuries, offering advantages over the DASH score.