Perilunate dislocation and fracture dislocation: A critical analysis of the volar-dorsal approach

Sotereanos, Dean G.; Mitsionis, Grigoris J.; Giannakopoulos, Panayotis N.; Tomaino, Matthew M.; Herndon, James H.

doi:10.1016/s0363-5023(05)80179-0

Cited by 114 publications

(87 citation statements)

References 17 publications

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“…In our series, the incidence of grade 2 and 3 arthritis was 36 % with an average follow-up of 24.3 months. In studies with an average follow-up of 2-2.5 years, the arthritis rate was 18−22 % [1,13,14,24,25], while studies with a follow-up period of 6-12 years showed the arthritis rate to be as high as 50-100 % [5,10,23]. A high percentage of these severe injuries, with chondral fractures and articular impaction, appears to progress to some degree of arthrosis over time.…”

Section: Discussionmentioning

confidence: 99%

“…Through the volar approach, the lunate can be reduced and the volar capsule repaired. The dorsal approach provides access to Table 4 Review of the studies on the combined volar-dorsal approach for perilunate dislocations and fracture-dislocations [1,7,12,13,17,24] Author (year) reduce the scapholunate and lunate-triquetral articulations and fix scaphoid fracture from an antegrade approach [24]. We immobilized the wrist for 10 weeks to assure satisfactory ligament healing [3].…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…Dorsal, volar, and combined approaches have been described for the surgical treatment of perilunate injuries. Although better visualization can be achieved with a combined approach, there is suspicion of increased risk of wound healing complications, swelling, and interruption of blood supply to the carpus [7]. The dorsal approach is known for allowing good exposure of the proximal carpal row, midcarpal joints, and proximal pole of scaphoid.…”

Section: Discussionmentioning

confidence: 99%

“…Sotereanos et al [7] reported 11 cases with perilunate injuries, 8 of which were trans-scaphoid perilunate injuries. These trans-scaphoid perilunate injuries were treated with open reduction and fixation of the scaphoid fractures.…”

Section: Discussionmentioning

confidence: 99%

Treatment of an Unusual Trans-Scaphoid Perilunate Avulsion Fracture Dislocation: A Case Report

Moody

Zhang

2014

Hand (New York, N,Y.)

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We describe an unusual case of trans-scaphoid perilunate injury where the proximal half of the scaphoid avulsed from all attaching ligaments and extruded into the forearm. Treatment involved anatomic reduction and internal fixation of the fracture, scapholunate (SL) ligament repair, temporary K-wire fixation, and prolonged immobilization. At 19-month follow-up, the fracture healed, SL ligament remained intact, and the patient recovered much of his hand function.

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“…Traditionelle Therapieoptionen sind die geschlossene Reposition und Gipsretention, die perkutane Kirschner-Draht-Transfixation, die offene Versorgung über einen dorsalen oder palmaren Zugang und die Behandlung über einen kombinierten Zugang [17,19,25,27]. Einen neuen Therapie ansatz stellt die arthroskopisch assistierte Versorgung dar [10,12,29].…”

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Diagnostik und Therapie von perilunären Luxationen und Luxationsfrakturen

2012

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Perilunate dislocations, dislocation fractures and lunate dislocations are rare injuries predominantly resulting from hyperextension of the wrist during high-energy trauma. Early recognition and treatment of these injuries usually results in good functional outcome despite degenerative changes on radiographs. Immediate reduction and adequate restoration of normal alignment are the key to successful healing. Surgical intervention with open reduction and ligament repair aims at stable reconstruction of the carpus. It requires broad surgical experience and a profound knowledge of normal anatomy.

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Perilunate dislocation and fracture dislocation: A critical analysis of the volar-dorsal approach

Cited by 114 publications

References 17 publications

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

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

Treatment of an Unusual Trans-Scaphoid Perilunate Avulsion Fracture Dislocation: A Case Report

Diagnostik und Therapie von perilunären Luxationen und Luxationsfrakturen

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