Pediatric and Adolescent Perilunate Injuries: Clinical Presentation, Injury Characteristics, and Outcomes

Area of Science:

• Orthopedic Surgery
• Pediatric Traumatology
• Hand and Wrist Injuries

Background:

• Fracture dislocations of the carpus are uncommon, especially in pediatric populations.
• Perilunate injuries in children require thorough evaluation of injury patterns and treatment outcomes.

Purpose of the Study:

• To characterize the injury patterns, clinical presentation, and treatment outcomes of pediatric perilunate injuries.
• To identify factors influencing outcomes in surgically treated children with perilunate injuries.

Main Methods:

• Retrospective chart review and prospective follow-up of pediatric patients undergoing operative treatment for perilunate injuries.
• Data collected included time to treatment, injury characteristics, surgical details, complications, and patient-reported outcomes.
• Descriptive statistics were employed for data analysis.

Main Results:

• Fifteen pediatric patients (mean age 14.2 years) were included, with 87% being male.
• Average delay to surgery was 27 days; 67% of injuries resulted from high-energy mechanisms.
• The scaphoid was fractured in 73% of cases; younger children (<10 years) showed a transcapitate pattern. Follow-up demonstrated good range of motion and strength, with maintained carpal alignment.

Conclusions:

• Pediatric perilunate injuries are rare, often linked to high-energy trauma and delayed treatment.
• Transscaphoid patterns are common in adolescents, while younger children may present with transcapitate injuries.
• Surgical management yields favorable outcomes exceeding one year, even with treatment delays.