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[Carpal perilunar dislocation. Clinical study (apropos of 39 cases)]
T Fikry1, A Lamine, A Harfaoui
1Service de Chirurgie Orthopédique et Réparatrice Aile 4, Casablanca, Maroc.
Acta Orthopaedica Belgica
|January 1, 1993
Summary
Carpal perilunar dislocations are often missed, leading to poor outcomes. Early diagnosis with lateral wrist X-rays and prompt surgical repair via a palmar incision are crucial for better results.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Imaging
- Trauma Care
Background:
- Carpal perilunar dislocations represent challenging injuries with variable outcomes.
- Current treatment strategies lack standardization, contributing to diagnostic and therapeutic difficulties.
Purpose of the Study:
- To clarify diagnostic and treatment issues associated with carpal perilunar dislocations.
- To evaluate outcomes of different management strategies in a retrospective cohort.
Main Methods:
- Retrospective analysis of 39 cases of carpal perilunar dislocations.
- Review of diagnostic accuracy, surgical interventions, and functional/anatomic outcomes.
Main Results:
- Diagnosis was established in 66% of fresh dislocations.
- Surgical treatment in 26 cases revealed nonunion, necrosis, and instability.
- Open dislocations and non-operative treatment resulted in worse functional outcomes.
- Scaphoid screwing showed superior results compared to pinning.
- Palmar incision for surgery improved bone and ligament repair, reducing arthritis risk.
Conclusions:
- Lateral wrist X-rays are essential for timely diagnosis of wrist trauma.
- Systematic use of palmar incision in surgical repair optimizes outcomes and minimizes complications.