Dorsal perilunate dislocations and fracture-dislocations: Questionnaire, clinical, and radiographic evaluation

Hildebrand, Kevin A.; Ross, Douglas C.; Patterson, Stuart D.; Roth, James H.; MacDermid, Joy C.; King, Graham J.W.

doi:10.1053/jhsu.2000.17868

Cited by 117 publications

(104 citation statements)

References 22 publications

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“…Table 4 shows a review of the studies on the combined volardorsal approach for perilunate dislocations and fracture-dislocations. Our study results were similar to the study of Hildebrand et al [12] for functional outcome measures: flexion-extension, 82±29°vs. 82±40°; pronation-supination, 155±33°vs.…”

Section: Discussionsupporting

confidence: 92%

“…The differences between perilunate dislocations and fracture-dislocations have been repeatedly discussed in the literature, with conflicting reports [12]. In our study, although perilunate dislocations had a greater increase in scapholunate angle compared to the fracture-dislocation group, the final hand range of motion and grip strength were similar.…”

Section: Discussioncontrasting

confidence: 41%

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Treatment of Dorsal Perilunate Dislocations and Fracture–Dislocations Using a Standardized Protocol

Capo¹,

Corti

Shamian

et al. 2012

Hand (New York, N,Y.)

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Background The aims of this study were to evaluate the associated injuries occurring with acute perilunate instability and to assess the clinical and radiographic outcomes of perilunate dislocations and fracture-dislocations treated with a combined dorsal and volar approach. Methods A total of 45 patients (46 wrist injuries) with perilunate dislocations and fracture-dislocations were prospectively evaluated. The size of the mid-carpal ligament tear, the location of the scapholunate ligament tear, and the presence of osteochondral fragments and of the dorsal radiocarpal ligament avulsions were recorded at injury. Final clinical and radiographic outcomes were evaluated in 25 cases (25 wrists) with a minimum of 6 months of follow-up. Results Intraoperative examination of the 46 cases with operative treatment showed the volar carpal ligament tear to be present 100 % of the time and to be an average length of 3.4 cm. Complete avulsion of the dorsal extrinsic radiocarpal ligaments was found in 65.2 % of cases. The scapholunate ligament was torn in 35 cases. Osteochondral fragments were found either volarly or dorsally in 74 % of the cases. The average flexion-extension arc was 82°, forearm rotation was 155°, and grip strength averaged 59 % of the uninjured hand. The average final scapholunate angle was 55°and the scapholunate gap was 2.2 mm. Conclusion Treatment of perilunate fracture-dislocations with a combined volar and dorsal approach results in reasonable and functional clinical results. The incidence of associated injuries with these carpal dislocations is high. Although the perilunate fracture-dislocations have a slightly better radiologic alignment than the dislocation group, the clinical outcome is similar.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 41%

Treatment of Dorsal Perilunate Dislocations and Fracture–Dislocations Using a Standardized Protocol

Capo¹,

Corti

Shamian

et al. 2012

Hand (New York, N,Y.)

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“…Open treatment of PLDs using dorsal or dorsal and volar combined incisions, for reduction and ligament repair have also shown poor results. 7,22,23 Hildebrand et al 24 performed an open reduction through a combined dorsal and volar approach on a mixed cohort of patients who sustained both PLDs and perilunate fracture dislocations (PLFDs). 24 Despite good Mayo scores and wrist range of movement they reported high complication rates and poor patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

“…7,22,23 Hildebrand et al 24 performed an open reduction through a combined dorsal and volar approach on a mixed cohort of patients who sustained both PLDs and perilunate fracture dislocations (PLFDs). 24 Despite good Mayo scores and wrist range of movement they reported high complication rates and poor patient satisfaction. Trumble et al 25 described combined dorsal and volar approach with repair of the SLIL, protected by a looped interosseous cerclage wire, to give better compression across the SL interval compared to K-wires.…”

Section: Discussionmentioning

confidence: 99%

“…Apart from equivocal results achieved with closed and open methods of treatment, implant failure, and other surgical complications such as flexor tendon adhesions, superficial and deep wound sepsis and arthrofibrosis should be taken into account when considering the open treatment of PLDs. 1,22,[24][25][26] Table II compares this study with several other studies assessing the open treatment of these lesser arc injuries. The results of our study are comparable in most included fields.…”

Section: Discussionmentioning

confidence: 99%

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