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The unreduced carpal dislocation. A method of treatment
Clinical Orthopaedics and Related Research
|January 1, 1986
Summary
Treating unreduced wrist dislocations requires surgical intervention. A combined dorsal and palmar approach with open reduction and internal fixation is recommended for stability, with carpal tunnel decompression if needed.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Traumatology
Background:
- Unreduced carpal dislocations, including lunate, perilunate, and transscaphoid perilunate types, pose significant surgical challenges.
- Restoring carpal anatomy and function in chronic dislocations is crucial for patient outcomes.
Observation:
- The authors advocate for maximal efforts to achieve reduction of old carpal dislocations.
- A combined dorsal and palmar surgical approach facilitates open reduction and internal fixation.
Findings:
- Internal fixation of the scaphoid bone with a Herbert screw is recommended to ensure midcarpal stability.
- Carpal tunnel decompression is advised if median nerve entrapment is suspected.
Implications:
- For irreducible dislocations without significant arthritis, limited wrist arthrodesis or proximal row carpectomy are considered viable alternatives.
- This approach aims to salvage wrist function and alleviate pain in complex carpal instability cases.