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Lunate and perilunate dislocation

C J Su1, M C Chang, Y Liu

  • 1Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|November 1, 1996
PubMed
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Prompt treatment of perilunate dislocations, especially those involving fractures, leads to better outcomes. Delayed surgery and specific fixation methods are linked to poorer prognoses for this uncommon wrist injury.

Area of Science:

  • Orthopedic surgery
  • Traumatology
  • Wrist biomechanics

Background:

  • Perilunate dislocation is a rare wrist injury often caused by hyperextension.
  • Prognostic factors for perilunate dislocations remain debated.
  • This study investigates fracture types, associated injuries, surgical timing, fixation techniques, and outcomes.

Purpose of the Study:

  • To analyze factors influencing the prognosis of perilunate dislocations.
  • To evaluate different treatment strategies and their effectiveness.
  • To identify predictors of successful outcomes in perilunate dislocation management.

Main Methods:

  • Retrospective review of 14 patients with perilunate dislocation or fracture-dislocation.
  • Treatment involved open reduction and internal fixation.

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  • Follow-up included functional scoring and radiographic assessment for at least 12 months.

    • Main Results:

    • Overall, 8 out of 14 patients achieved good or excellent results.
    • Two patients had fair results, and two had poor results.
    • Delayed treatment (>1 month), transscaphoid perilunar fracture-dislocation, and Kirschner wire fixation were associated with inferior outcomes.

    Conclusions:

    • Early diagnosis and prompt surgical intervention are crucial for favorable outcomes.
    • Open reduction, rigid fixation, and ligament repair improve results for perilunate dislocations.
    • Avoiding treatment delays and specific fracture patterns can enhance prognosis.