A Case for Acute Proximal Row Carpectomy for Perilunate Injuries

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Trauma Surgery

Background:

• Perilunate injuries are severe wrist traumas often resulting from high-energy incidents.
• Current standard treatments like open reduction and internal fixation can lead to complications such as pain, stiffness, and arthritis.
• Proximal row carpectomy has been explored as a salvage option for advanced carpal injuries with substantial bone or cartilage damage.

Purpose of the Study:

• To evaluate proximal row carpectomy as an initial treatment for perilunate injuries.
• To compare functional outcomes of primary proximal row carpectomy with traditional ligamentous reconstruction.

Main Methods:

• A retrospective review of two patients with perilunate dislocations treated with primary proximal row carpectomy.
• Assessment of radiocarpal alignment and functional outcomes using Quick-DASH scores at over one-year follow-up.

Main Results:

• Both patients achieved stable radiocarpal alignment one year post-surgery.
• Functional outcome scores (Quick-DASH) were 22.7 and 27.3, indicating moderate functional improvement.

Conclusions:

• Primary proximal row carpectomy presents a viable acute treatment option for perilunate injuries in elderly, lower-demand individuals.
• This surgical approach yields functional results similar to ligamentous reconstruction but with an expedited recovery period.