Arthroscopic treatment of a fresh lunate bone fracture detaching the scapholunate ligament

Dana, C; Doursounian, Levon; Nourissat, Geoffroy

doi:10.1016/j.main.2010.01.001

Cited by 18 publications

(16 citation statements)

References 7 publications

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“…1,2,6 Defi nitive management of displaced lunate fractures focuses on immediate anatomic reduction using open reduction and internal fi xation with Kirschner wires and microscrews to improve anatomic alignment and functional status and to decrease the risk of future osteonecrosis. 13 Dana et al 16 recently reported a case of a dorsal pole avulsion fracture of the lunate with a bony fragment detaching the posterior part of the scapholunate ligament, which was treated successfully with arthroscopic percutaneous screw repair. In cases of delayed presentation with chronic carpal instability and arthrosis, salvage operations such as proximal row carpectomy and wrist arthrodesis are often performed.…”

Section: A 4b 4cmentioning

confidence: 99%

Unusual Case of Isolated Lunate Fracture Without Ligamentous Injury

Hsu¹,

Hsu²

2011

Orthopedics

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Fractures of the lunate are rare injuries that usually result from high-energy trauma and are typically associated with other carpal and ligamentous injuries. The incidence of lunate fractures has been cited as 0.5% to 6.5% of all carpal fractures. These fractures are not frequently reported in the literature, and no consensus exists on the treatment of these injuries in the acute and chronic setting. The mechanism typically producing this fracture is a loading force applied to a dorsiflexed, ulnarly deviated wrist such that the capitate is driven downward into the lunate.No prior reports exist in the literature of an isolated fracture of the lunate without perilunate dislocation or ligament disruption. This article reports a case of an isolated displaced transverse shear fracture of the lunate seen 3 months after initial injury, which was successfully treated using a volar and dorsal combined approach and open reduction and internal fixation using microscrews. Bony union across the fracture site was obtained by 7-week follow-up and continued to show improved consolidation through 10-month follow-up. The patient had decreased pain, normal range of motion, and no radiographic evidence of lunate osteonecrosis on most recent follow-up despite the delayed presentation and degree of fracture displacement. This case demonstrates a previously unreported type of wrist injury.

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Section: A 4b 4cmentioning

confidence: 99%

Unusual Case of Isolated Lunate Fracture Without Ligamentous Injury

Hsu¹,

Hsu²

2011

Orthopedics

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“…Kang et al performed closed reduction and fixation with a percutaneous compression screw, while respecting the dorsal metacarpal ligaments and keeping with the ligamentotaxis principle [1]. In our opinion, arthroscopy has no place in the treatment of complex carpal fractures affecting both carpal rows but may be an option in cases of isolated fractures of the proximal row to verify reduction and determine if the ligaments are intact [25,26]. This is the first published case report describing a coronal fracture of the ulnar column.…”

Section: Discussionmentioning

confidence: 98%

A rare coronal fracture of the medial carpal column: Case report

Dunet

Vargas

Tournier

et al. 2015

Chirurgie de la Main

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“…Hsu and Hsu (14) by the dual approach openly reduced and fixed by headless screw a case of type V isolated lunate fracture, three months after injury. Dana et al successfully applied arthroscopic techniques in inserting percutaneous screw to treat a case of a dorsal pole avulsion fracture of the lunate with a bony fragment detaching the posterior part of the scapholunate ligament (23). Failure to reduce and fix the avulsed fragment because of comminution, the possibility of its avascular necrosis and no significant ligamentous attachment on it justified us to intra-operatively judge on excising the fragment and not to insist on unstable fixation and following complications.…”

Section: Discussionmentioning

confidence: 99%

Lunate Osteochondral Fracture Treated by Excision: A Case Report and Literature Review

2016

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IntroductionLunate fracture is a rare injury. Most reports are associated with other wrist injuries such as perilunate dislocation and distal radius fracture. Isolated lunate fracture has been reported even more rarely. The choice of treatment and outcomes are consequently undetermined.Case PresentationIn this case report we will describe a lunate avulsion fracture as an isolated injury after a fall from nine meters treated operatively by excision of the comminuted avulsed fragment. After 33 months of follow-up radiographs showed no sign of degenerative joint disorder on simple X-ray, but slight Volar Intercalated Segment Instability (VISI) by a capitolunate angle of 26 degrees was noted. Clinically, the patient was pain free near full wrist and forearm range of motion and could perform his previous vocational and recreational tasks without any limitations.ConclusionsDespite apparently good short and mid-term clinical outcome, slight volar intercalated segment instability after 33 months of follow-up revealed that lunotriquetral ligament function was probably lost, which led to static instability. This ligament injury may be missed primarily. Excision of the avulsed osteochondral fragment should be the last option of treatment and most attempts should be tried to fix and/or restore the normal anatomy of ligamentous structure.

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Arthroscopic treatment of a fresh lunate bone fracture detaching the scapholunate ligament

Cited by 18 publications

References 7 publications

Unusual Case of Isolated Lunate Fracture Without Ligamentous Injury

Unusual Case of Isolated Lunate Fracture Without Ligamentous Injury

A rare coronal fracture of the medial carpal column: Case report

Lunate Osteochondral Fracture Treated by Excision: A Case Report and Literature Review

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