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Medium-Term Patient-Reported Outcomes after Surgical Management of Perilunate Injury: A Multiinstitutional Experience.

Journal of wrist surgery·2025

Related Experiment Video

Updated: May 28, 2025

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Perilunate Dislocation Reduction Technique and Results.

Olivia Jagiella-Lodise1, Aidan Sweeney2, Paul Ghareeb2

  • 1University of Pennsylvania, Philadelphia, USA.

Hand (New York, N.Y.)
|February 14, 2025
PubMed
Summary

Closed reduction of perilunate dislocations in the emergency department is highly successful, with over 80% of cases achieving reduction. This method effectively resolves median nerve symptoms in most patients, offering a safe initial treatment option.

Keywords:
Herzbergcarpal tunnel syndromediagnosisfracture/dislocationlunatenerveperilunatereductionwrist

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Area of Science:

  • Orthopedic Surgery
  • Emergency Medicine
  • Hand and Wrist Surgery

Background:

  • Perilunate dislocations are severe wrist injuries involving ligamentous damage.
  • Previous literature indicates a low success rate (25%) for closed reduction of these injuries.

Purpose of the Study:

  • To describe the technique and outcomes of closed reductions for perilunate dislocations.
  • To evaluate the success rate and impact on median nerve symptoms.

Main Methods:

  • Retrospective chart review of 56 perilunate injuries (2017-2022).
  • Classification of injuries using the Herzberg staging system.
  • Closed reduction performed in the emergency department (ED) via traction, relaxation, and manipulation.

Main Results:

  • 80% of injuries (45/56) underwent attempted closed reduction, with a 82% success rate (37/45).
  • Median nerve symptoms were present in 54% of patients and resolved in 92% after reduction.
  • Successful reduction was not associated with Herzberg stage; scaphoid fractures did not impact success.

Conclusions:

  • Closed perilunate reduction in the ED achieves a high success rate (>80%) and effectively resolves median nerve compression.
  • This technique is a safe and viable initial management strategy for perilunate dislocations prior to surgical intervention.