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. 2024 Jul;34(5):2751-2756.
doi: 10.1007/s00590-024-03999-3. Epub 2024 May 18.

Surgical management and functional outcomes of perilunate dislocations and fracture dislocations through the dorsal approach

Eleni Pappa  1 , Chrysoula Argyrou  2 , George Tetsios  2 , Margarita-Michaela Ampadiotaki  2 , Sophia Syngouna  2 , Panagiotis Kanellos  2 , Emmanouil Fandridis  2
Affiliations

Surgical management and functional outcomes of perilunate dislocations and fracture dislocations through the dorsal approach

Eleni Pappa et al. Eur J Orthop Surg Traumatol. 2024 Jul.

Abstract

Background: Perilunate dislocations and perilunate fracture dislocations (PLD/PLFDs) are rare injuries of the wrist, with surgical management leading to acceptable functional results.

Purpose: The purpose of this study was to assess the functional outcomes of the patients of our department who were treated with surgical management of PLDs/PLFDs through dorsal approach, as well as to report any complications on their follow-up.

Patients and methods: In this retrospective study, 52 patients with PLD/PLFD, fulfilling the inclusion and exclusion criteria of the study, underwent surgical management of their injury. All patients were followed up at 6 weeks, 12 weeks, 6 months, 1 year postoperatively with radiographic imaging as well as functional scores measured with the modified mayo wrist score and the QuickDASH questionnaire.

Results: The mean postoperative modified Mayo score was 76.8 ± 8.8 and the mean QuickDASH score was 1.52 ± 2.18. Of the 52 cases, 20% had excellent results, 42% had good results, 29% had fair results and 9% had poor results as per the modified Mayo wrist score. No patient signed any symptoms of median nerve neuropathy.

Conclusion: In conclusion, open reduction and internal fixation through dorsal approach is a reliable technique to manage perilunate injuries in spite of radiological evidence of wrist arthritis, as it also provides consistently good results in terms of functional outcomes.

Level of evidence iv: Retrospective case series study.

Keywords: Hand; Perilunate dislocation; Perilunate fracture dislocation; Upper limb.

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