Treatment of Trans-Scaphoid Perilunate Dislocations Using a Volar Approach With Scaphoid Osteosynthesis and Temporary Kirschner Wire Fixation

Malović, Mario; Pavić, Roman; Milošević, Milan

doi:10.7205/milmed-d-10-00419

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…In those cases fixation of the scaphoid is recommended 19. In our study, two scaphoid fractures and radial styloid fracture healed without complications.…”

Section: Discussionsupporting

confidence: 54%

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

Başar

Erol

et al. 2014

IJOO

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Background:Volar and/or dorsal surgical approaches are used for surgical treatment of perilunate and lunate dislocations. There are no accepted approaches for treatment in the literature. We evaluated the functional results of isolated volar surgical approach for the treatment of perilunate and lunate dislocation injuries.Materials and Methods:9 patients (6 male and 3 female patients average age 34.5 ± 3.6 years) diagnosed with perilunate or lunate dislocations between January 2000 and January 2009 were involved in the study. The reduction was performed through isolated volar surgical approach and K-wire fixation, fracture stabilization with volar ligament repair was performed. Range of wrist joint motion, fracture healing, carpal stability, grip strength, return to work were evaluated and also direct radiographs were taken routinely at each control. The scapholunate interval and the scapholunate angle were evaluated radiographically. Evaluations of the clinical results were done using the DASH, VAS and Modified Mayo Wrist Scores.Results:The physical rehabilitation was started at 6th week, after the K-wires were removed. The average followup was 18.2 months (range 12-28 months). At the final followup, the average flexion extension arc was 105.0 ± 9.6° (74.6% of the other side), the average rotation arc was 138.8 ± 7.8° (81.5% of the other side) and the average radioulnar arc was 56.1 ± 9.9° (86.4% of the other side). The grip strength was 0.55 bar; 83.2% that the uninjured arm. According to the Mayo Modified Wrist score, the functional result was excellent in five patients and good in four and the average DASH score was 22.8. The scapholunate interval was 2.1 mm and scapholunate angle was 51°.Conclusion:The clinical and radiological results of the isolated volar surgical approach were satisfactory. The dorsal approach was not needed for reduction of dislocations during operations. Our results showed that an isolated volar approach was adequate.

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“…In those cases fixation of the scaphoid is recommended 19. In our study, two scaphoid fractures and radial styloid fracture healed without complications.…”

Section: Discussionsupporting

confidence: 54%

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

Başar

Erol

et al. 2014

IJOO

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“…14–18 Various surgical techniques have been described with a majority showing acceptable outcomes with open reduction and internal fixation. 12,19–24 Although most reports describe open approaches, these involve soft-tissue dissection that have been shown to increase the risk of disrupting the blood supply to the scaphoid. 25 Closed reduction with percutaneous fixation has been shown to have excellent functional outcomes in patients with trans-scaphoid perilunate injuries.…”

Section: Discussionmentioning

confidence: 99%

Trans-scaphoid Trans-lunotriquetral Perilunate Dislocation in a Patient with a Carpal Coalition

Xipoleas

Villanueva

Ting

2014

Plastic and Reconstructive Surgery Global Open

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Summary:Congenital carpal coalitions are rare conditions that arise from a failure or an incomplete cavitation of a common cartilaginous precursor of the carpal bones between the fourth and eighth week of intrauterine life. The incidence of coalitions has been estimated to occur in about 0.1% of the population and up to 1.6% in people of African descent. This study reports a case of trans-scaphoid trans-lunotriquetral perilunate dislocation with a lunotriquetral coalition and successful management with closed reduction, percutaneous fixation, and a thumb spica cast.

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“…5 Perilunate injuries are misdiagnosed and consequently treated suboptimally in 25% of the cases due to pathoanatomic complexity and clinician inexperience. 1,2,[5][6][7] Several classifications are known, which all describe the carpal dislocation process. 8 Most notably is the Mayfield classification (►Fig.…”

mentioning

confidence: 99%

“…Perilunate injuries are uncommon yet challenging and often missed injuries, representing 7% of all carpal traumas. 1 2 3 4 A high-energy trauma on a hyperextended wrist is the most common mechanism. 5 Perilunate injuries are misdiagnosed and consequently treated suboptimally in 25% of the cases due to pathoanatomic complexity and clinician inexperience.…”

mentioning

confidence: 99%

Perilunate Injury Timing and Treatment Options: A Systematic Review

et al. 2021

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Introduction Perilunate injuries are uncommon yet challenging and often missed injuries, representing 7% of all carpal traumas. Two types of injuries can be identified as follows: perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD). The purpose of this study was to conduct a systematic review and meta-analysis to establish which surgical treatment is superior for patients with perilunate injuries and the significance of delayed treatment. Methods A total of 2056 articles were screened, and 16 articles were included. Risk of bias for case-control series and case series were assessed through the National Institute of Health study quality assessment tool. Qualitative outcomes of clinical scores for hand function were compared between different time points (acute, < 7 days; delayed 7–45 days; chronic > 45 days), open and closed reduction, and PLD and PLFD. Results Overall, the clinical outcome scores of patients treated within 7 days are good. The results suggest that closed reduction and internal fixation (CRIF) offers slightly better outcomes than open reduction and internal fixation (ORIF) for PLFD. Patients treated 6 weeks or more after the initial injury seem to have the worst overall outcomes than patients in the acute or delayed setting. The results suggest that patients with chronic PLD have even worse outcomes than patients with chronic PLFD. Conclusions Timing of surgery is essential for an optimal outcome. When there is a delay of treatment, the outcomes are inferior to those treated acutely. Early referral to centralized treatment units for perilunate injuries would allow for targeted treatment and facilitate research on this difficult wrist injury.

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Treatment of Trans-Scaphoid Perilunate Dislocations Using a Volar Approach With Scaphoid Osteosynthesis and Temporary Kirschner Wire Fixation

Cited by 9 publications

References 19 publications

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

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

Trans-scaphoid Trans-lunotriquetral Perilunate Dislocation in a Patient with a Carpal Coalition

Perilunate Injury Timing and Treatment Options: A Systematic Review

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