Surgical treatment of acute perilunate dislocations and fracture dislocation in a specialized center

Authors

DOI:

https://doi.org/10.25214/28056272.1176

Keywords:

Articulaciones del carpo, Huesos del carpo, Hueso escafoides, Muñeca, Inestabilidad de la articulación, Fractura luxación

Abstract

Introduction: Acute perilunate dislocations and fracture-dislocations are rare, high energy injuries and difficult to treat due to the extensive soft tissue, cartilage, and bone involvement. Different treatment options have been recommended with a recent trend in open reduction and internal fixation.

Objective: To evaluate a cohort of patients who received specific surgical treatment for acute perilunate dislocations and fracture dislocations in a specialized center in trauma and hand surgery.

Methods: Descriptive cross-sectional study performed in 20 patients diagnosed with acute perilunate dislocations and fracture-dislocations treated surgically. Patients who underwent surgery between February 2008 and February 2014 were assessed and sociodemographic data, trauma mechanism, follow-up time, visual analog pain scale, DASH scale and joint mobility arches were assessed. The clinical results were obtained through a personal interview and clinical assessment.

Results: The average age of the patients was 32 years old and the dominant hand was the most affected (80%). Perilunate dislocations were the most frequent (50%), followed by transscapholunar (40%) and transstyloradial (10%) dislocations. 2 complications were founded.

Conclusions: All patients underwent a timely surgical procedure and had a good recovery, so it is established that early surgical treatment (<72 hours) is an important factor in obtaining favorable clinical and functional results. This is the first study that analyzes the results of surgical management of these conditions in Colombia.

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Author Biographies

Alejandro Satizábal, Universidad Nacional de Colombia

Universidad Nacional de Colombia, Facultad de Medicina, Unidad de Ortopedia y Traumatología, Bogotá D.C., Colombia.

Diego Alejandro Dávalos Herrera, Universidad Nacional de Colombia

Universidad Nacional de Colombia, Facultad de Medicina, Unidad de Ortopedia y Traumatología, Bogotá D.C., Colombia.

Elkin Augusto Lozano González, Universidad Nacional de Colombia

Universidad Nacional de Colombia, Facultad de Medicina, Unidad de Ortopedia y Traumatología, Bogotá D.C., Colombia. Clínica Asotrauma, Ibagué, Colombia.

References

Najarian R, Nourbakhsh A, Capo J, Tan V. Perilunate injuries. Hand (N Y). 2011;6(1):1-7. DOI: 10.1007/s11552-010-9293-5. https://doi.org/10.1007/s11552-010-9293-5

Hildebrand KA, Ross DC, Patterson SD, Roth JH, MacDermid JC, King GJ. Dorsal perilunate dislocations and fracture-dislocations: questionnaire, clinical, and radiographic evaluation. J Hand Surg Am. 2000;25(6):1069-79. DOI: 10.1053/jhsu.2000.17868. https://doi.org/10.1053/jhsu.2000.17868

Herzberg G. Perilunate and axial carpal dislocations and fracture-dislocations. J Hand Surg Am. 2008;33(9):1659-68. DOI: 10.1016/j.jhsa.2008.09.013. https://doi.org/10.1016/j.jhsa.2008.09.013

Jones DB Jr, Kakar S. Perilunate dislocations and fracture dislocations. J Hand Surg Am. 2012;37(10):2168-73. DOI:10.1016/j.jhsa.2012.07.034. https://doi.org/10.1016/j.jhsa.2012.07.034

Sawardeker PJ, Kindt KE, Baratz ME. Fracture-dislocations of the carpus: perilunate injury. Orthop Clin North Am. 2013;44(1):93-106. DOI: 10.1016/j.ocl.2012.08.009. https://doi.org/10.1016/j.ocl.2012.08.009

Stanbury SJ, Elfar JC. Perilunate dislocation and perilunate fracture-dislocation. J Am Acad Orthop Surg. 2011;19(9):554-62. DOI: 10.5435/00124635-201109000-00006. https://doi.org/10.5435/00124635-201109000-00006

Sauder DJ, Athwal GS, Faber KJ, Roth JH. Perilunate injuries. Hand Clin. 2010;26(1):145-54. DOI: 10.1016/j.hcl.2009.08.004. https://doi.org/10.1016/j.hcl.2009.08.004

Martinage A, Balaguer T, Chignon-Sicard B, Monteil MC, Dréant N, Lebreton E. Luxations et fractures-luxations périlunaires du carpe, étude rétrospective d'une série de 14 cas. Chir Main. 2008;27(1):31-9. DOI: 10.1016/j.main.2007.10.006. https://doi.org/10.1016/j.main.2007.10.006

Herzberg G, Comtet JJ, Linscheid RL, Amadio PC, Cooney WP, Stalder J. Perilunate dislocations and fracture-dislocations: a multicenter study. J Hand Surg Am. 1993;18(5):768-79. DOI: 10.1016/0363-5023(93)90041-Z. https://doi.org/10.1016/0363-5023(93)90041-Z

Mayfield JK. Mechanism of carpal injuries. Clin Orthop Relat Res. 1980;(149):45-54.

Herzberg G. Acute Dorsal Trans-scaphoid Perilunate Dislocations: Open Reduction and Internal Fixation. Tech Hand Up Extrem Surg. 2000;4(1):2-13. DOI: 10.1097/00130911-200003000-00002. https://doi.org/10.1097/00130911-200003000-00002

Souer JS, Rutgers M, Andermahr J, Jupiter JB, Ring D. Perilunate fracture-dislocations of the wrist: comparison of temporary screw versus K-wire fixation. J Hand Surg Am. 2007;32(3):318-25. DOI: 10.1016/j.jhsa.2007.01.008. https://doi.org/10.1016/j.jhsa.2007.01.008

Kremer T, Wendt M, Riedel K, Sauerbier M, Germann G, Bickert B. Open reduction for perilunate injuries--clinical outcome and patient satisfaction. J Hand Surg Am. 2010;35(10):1599-606. DOI: 10.1016/j.jhsa.2010.06.021. https://doi.org/10.1016/j.jhsa.2010.06.021

Reyes-Reyes CJ, Valencia-Chamorro MP, García-González LA. Osteosíntesis de la diáfisis del húmero con placas. Serie de casos. Rev. Col. de Or. Tra. 2005;19(4):27-33.

Budoff JE. Treatment of acute lunate and perilunate dislocations. J Hand Surg Am. 2008;33(8):1424-32. DOI: 10.1016/j.jhsa.2008.07.016. https://doi.org/10.1016/j.jhsa.2008.07.016

Trumble T, Verheyden J. Treatment of isolated perilunate and lunate dislocations with combined dorsal and volar approach and intraosseous cerclage wire. J Hand Surg Am. 2004;29(3):412-7.DOI: 10.1016/j.jhsa.2004.01.009. https://doi.org/10.1016/j.jhsa.2004.01.009

Knoll VD, Allan C, Trumble TE. Trans-scaphoid perilunate fracture dislocations: results of screw fixation of the scaphoid and lunotriquetral repair with a dorsal approach. J Hand Surg Am. 2005;30(6):1145-52. DOI: 10.1016/j.jhsa.2005.07.007. https://doi.org/10.1016/j.jhsa.2005.07.007

Sotereanos DG, Mitsionis GJ, Giannakopoulos PN, Tomaino MM, Herndon JH. Perilunate dislocation and fracture dislocation: a critical analysis of the volar-dorsal approach. J Hand Surg Am. 1997;22(1):49-56. DOI: 10.1016/S0363-5023(05)80179-0. https://doi.org/10.1016/S0363-5023(05)80179-0

Herzberg G, Forissier D. Acute dorsal trans-scaphoid perilunate fracture-dislocations: medium-term results. J Hand Surg Br. 2002;27(6):498-502. DOI: 10.1054/jhsb.2002.0774. https://doi.org/10.1054/jhsb.2002.0774

Kural C, Tanriverdi B, Erçin E, Baca E, Yilmaz M. The surgical outcomes of trans-scaphoid perilunate fracture-dislocations. Turk J Med Sci. 2020;50(1):25-30. DOI: 10.3906/sag-1710-163. https://doi.org/10.3906/sag-1710-163

Published

2021-09-11

How to Cite

Satizábal, Alejandro, et al. “Surgical Treatment of Acute Perilunate Dislocations and Fracture Dislocation in a Specialized Center”. Cirugía De Mano Y Microcirugía, vol. 1, no. 1, Sept. 2021, pp. 11-14, doi:10.25214/28056272.1176.

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