Radially Displaced Perilunate Injuries: A Report of Two Cases.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Perilunate dislocations are uncommon wrist injuries.
• Radially displaced variants present unique challenges.
• Associated neurovascular complications, like ulnar nerve compression, can occur.

Purpose of the Study:

• To describe two unusual cases of radially displaced perilunate dislocations.
• To highlight the diagnostic and management complexities.
• To discuss the long-term outcomes and potential complications.

Main Methods:

• Case report presentation of two patients with radially displaced perilunate dislocations.
• Review of surgical interventions including closed reduction, open reduction, and ligament reconstruction.
• Assessment of neurovascular status and wrist joint stability post-treatment.

Main Results:

• Case 1: Closed reduction and casting led to scapholunate instability requiring secondary ligament reconstruction.
• Case 2: Open reduction and fixation resulted in persistent proximal row volar intercalated segment instability and ulnar nerve paresthesia.
• Both cases illustrate the potential for residual instability and neurological deficits.

Conclusions:

• Radially displaced perilunate dislocations are complex injuries with a propensity for significant complications.
• Management requires careful consideration of joint stability and neurovascular integrity.
• Long-term follow-up is crucial to address residual instability and nerve issues.