Isolated volar surgical approach for the treatment of perilunate and lunate dislocations

Başar, Hakan; Başar, Betül; Erol, Bülent; Tetik, Cihangir

doi:10.4103/0019-5413.132523

Cited by 11 publications

(4 citation statements)

References 20 publications

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“…Volar perilunate dislocations may frequently be associated with median nerve compression for which carpal tunnel decompression using the volar approach is required [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Volar Lunate Dislocation: A Case Report

Yadav,

Siwach,

Krishna

et al. 2024

jocr

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Introduction: Perilunate dislocations are rare high-energy injuries which may often have the potential to cause lifelong disability of the wrist if not addressed optimally. Hence, early recognition, diagnosis, and intervention are of paramount importance in the restoring function and prevention of morbidity. Lunate dislocations are the fourth and last stage of perilunate dislocations being extremely rare, with volar dislocations representing <3% of perilunate dislocations. Case Report: A 24-year-old man suffered from an alleged history of fall from a bike on an outstretched hand following which he developed complaints of pain and swelling in the right wrist. On examination, the patient has relative sensory loss over the lateral half of the palm with no vascular deficit. An accurate range of motion could not be documented due to severe pain. Standard digital X-rays revealed lunate displaced and angulated volarly with a typical “spilled teacup” appearance along with radial and ulnar styloid fractures. Management: The patient was initially given an attempt of closed reduction which was not successful and was followed with open reduction and internal fixation with both volar and dorsal approach with Kirschner wires. The patient’s wrist was immobilized for 6 weeks with below elbow cast with the removal of k wires at 8 weeks after which wrist ROM exercises were started. Results: The patient was followed up for 6 months and now has a functional range of motion of the wrist with no sensory deficit and is able to continue with his profession as a car mechanic. Conclusion: Mayfield progression Stage 4 perilunate dislocations are uncommon with a poor prognosis if not addressed timely. Hence, these injuries need to be identified early and optimally managed with surgical intervention for a favorable outcome. Keywords: Perilunate dislocation, carpal bones, avascular necrosis of lunate, wrist trauma, carpal instability

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“…Volar perilunate dislocations may frequently be associated with median nerve compression for which carpal tunnel decompression using the volar approach is required [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Volar Lunate Dislocation: A Case Report

Yadav,

Siwach,

Krishna

et al. 2024

jocr

View full text Add to dashboard Cite

show abstract

“…However, several studies have demonstrated comparable outcomes. Thus, the choice of approach is largely influenced by surgeon preference[ 10 - 13 ].…”

Section: Discussionmentioning

confidence: 99%

Lunate dislocation with avulsed triquetral fracture: A case report

Li¹,

Lin²,

Ko³

2022

WJCC

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BACKGROUND Lunate dislocation is an uncommon traumatic wrist injury that require prompt surgical management. Misdiagnosis or delayed treatment often leads to a poor outcome. Open reduction and surgical repair of disrupted ligaments are done in most cases to prevent long-term joint dysfunction. However, this method has certain limitations that include partial functional improvement, which poses a high risk for degenerative arthritis and wrist instability. CASE SUMMARY A 37-year-old man presented to the Emergency Department of our hospital following a motorcycle accident. Physical examination revealed swelling and tenderness of the right hand and wrist. The patient was initially misdiagnosed with a wrist contusion by an emergency physician, but was eventually diagnosed with lunate dislocation associated with a triquetral avulsed fracture, indicated for open reduction and ligament repair. We performed closed reduction and two Kirschner wire fixations following Tavernier’s method. The injured hand was protected with a standard short-arm orthosis for one month. The patient returned to normal daily work without discomfort at five months postoperatively. Encouragingly, there was no lunate necrosis or arthritis in the latest radiologic examinations. CONCLUSION This case provides evidence that the closed reduction technique for addressing such cases can reduce soft tissue destruction.

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“…Although the palmar ligaments in the scaphoid proximal pole are theoretically important stabilizers, it is difficult to repair them by direct observation 7 . There are also publications showing that possible carpal tunnel syndrome can be treated in the same session by using the volar approach 8 . The reason why we prefer the dorsal approach in our practice is to have the chance to directly observe the scapholunate interval in addition to reduction with the dorsal approach and subsequent pin placement with direct observation.…”

Section: Discussionmentioning

confidence: 99%