Management of Lunate and Perilunate Fracture Dislocation through Isolated Volar Approach: A Case Series of Ten Cases

Abstract

Objective: Lunate and perilunate fracture dislocations are complex injuries. Mayfield, Johnson, and Kilcoyne described four stages of progressive disruption of ligament attachments and anatomical relationships to the lunate resulting from forced wrist hyperextension. Urgent close reduction and pop slab is first line of management5.Unsatisfactory reduction and poor fixation at the same time can lead to poor treatment outcome. There are numerous surgical methods to treat such injuries. Methods: We describe here a series of ten cases of lunate and perilunate fracture dislocation treated by using single volar approach. Results: All patients gained full ROM in 6 months. We have longest follow up of 5 years (Fig 5,6) withMAYO15 wrist score 94. Conclusions: We strongly recommend isolated volar surgical approach for treating these injuries.