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Related Experiment Videos

Perilunate dislocations and fracture-dislocations: a multicenter study

G Herzberg1, J J Comtet, R L Linscheid

  • 1Hopital Edouard Herriot, Lyon, France.

The Journal of Hand Surgery
|September 1, 1993
PubMed
Summary
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Diagnosing perilunate dislocations and fracture-dislocations is often missed. Early open reduction and internal fixation improve outcomes, but post-traumatic arthritis remains common, highlighting the need for accurate initial assessment.

Area of Science:

  • Orthopedic Surgery
  • Trauma Care
  • Radiology

Background:

  • Perilunate dislocations and fracture-dislocations are severe wrist injuries.
  • Accurate diagnosis and timely treatment are crucial for optimal outcomes.
  • A significant percentage of these injuries are initially misdiagnosed.

Purpose of the Study:

  • To analyze the incidence, classification, and treatment outcomes of perilunate dislocations and fracture-dislocations.
  • To identify factors affecting clinical and radiologic results.
  • To emphasize the importance of accurate initial diagnosis and appropriate surgical management.

Main Methods:

  • Retrospective study of 166 perilunate dislocations and fracture-dislocations from 7 centers.
  • Analysis of initial diagnostic accuracy, injury patterns, and treatment strategies.

Related Experiment Videos

  • Evaluation of clinical and radiologic outcomes with an average follow-up of 6 years 3 months for 115 patients.

    • Main Results:

    • Initial diagnosis was missed in 25% of cases.
    • Dorsal displacement was predominant (97%).
    • Dorsal transscaphoid perilunate fracture-dislocations were the most common type (61%).
    • Open injury and delayed treatment negatively impacted results.
    • Early treatment yielded satisfactory clinical results, but post-traumatic arthritis occurred in 56%.
    • Open reduction and internal fixation provided the best radiologic results for specific injury types.
    • Incomplete fixation can lead to carpal instability and collapse.

    Conclusions:

    • Accurate initial assessment of both bone and ligament injuries is critical.
    • Early surgical intervention, particularly open reduction and internal fixation, is recommended for optimal outcomes.
    • Despite advances, the high incidence of post-traumatic arthritis necessitates further research into long-term management and prevention strategies.