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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Dorsal Spanning Plate for Perilunate Dislocations.

Duc M Nguyen1, Allison L Boden1, Megan K Allen1

  • 1Department of Orthopaedics, University of Miami, Miller School of Medicine, Miami, Florida.

Journal of Wrist Surgery
|February 7, 2022
PubMed
Summary

Open reduction, internal fixation with dorsal spanning plate (DSP) fixation for perilunate dislocations is as effective as traditional casting. This method allows early weight-bearing without compromising carpal stability.

Keywords:
carpal injurydorsal spanning platelimited temporary arthrodesisperilunate dislocation

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Area of Science:

  • Orthopedic Surgery
  • Radiographic Analysis
  • Trauma Care

Background:

  • Perilunate dislocations often require surgical intervention.
  • Traditional treatment involves open reduction, internal fixation (ORIF) with casting, limiting early mobility.
  • Dorsal spanning plate (DSP) fixation offers a potential alternative for enhanced stability and early load-bearing.

Purpose of the Study:

  • To compare radiographic outcomes of perilunate dislocation treatment.
  • To evaluate ORIF with casting versus ORIF with DSP fixation.
  • To determine if DSP fixation maintains carpal stability and allows early load-bearing.

Main Methods:

  • Retrospective radiographic review of 28 patients (2012-2018).
  • Comparison of scapholunate (SL) and lunotriquetral (LT) intervals post-surgery and post-hardware removal.
  • 13 patients treated with ORIF and casting, 15 with ORIF and DSP fixation.

Main Results:

  • No clinically significant difference in SL and LT intervals between the two groups.
  • Both treatment groups showed minimal changes in radiographic carpal stability markers.
  • DSP fixation did not increase carpal instability compared to casting.

Conclusions:

  • Dorsal spanning plate fixation is a viable alternative for perilunate dislocations.
  • DSP fixation with early load-bearing is not inferior to cast immobilization.
  • DSP fixation does not compromise carpal stability in treated perilunate dislocations.