[Perilunar dislocations of the carpus. Value of surgical treatment]

Between 1980 and 1990, 60 patients presenting with 62 peri-lunar dislocations of the carpus have been surgically treated. One case was a subluxation of the scaphoid and 61 were posterior perilunar dislocations, among them were 32 grade I, 23 grade II, 4 grade III, 2 unknown grade according to the Witvoët and Allieu scale. In 36 cases the scaphoid was fractured in 5 were associated a fracture of the scaphoid and a scapho-lunar dislocation. 48 cases have been reviewed after a 31 month follow-up average. The result was satisfactory in 83 per cent of these cases, unsatisfactory results being observed in cases of delayed surgery or incomplete reduction. In 36 cases a dynamic radiological examination was available after a 36 month follow-up average. 27 wrists were stable, 9 were not (7 D.I.S.I., 2 V.I.S.I.) 8 of these were related to unsatisfactory reductions. Diagnosis was delayed in 10 cases which ended with less satisfactory results. The authors think that conservative treatment is not adequate, they propose different surgical procedures according to the possible association of a fracture of the scaphoid.