A study on the Surgical Treatment of Perilumar Fracture-Dislocation
10.4055/jkoa.1994.29.4.1192
- Author:
Eun Sun MOON
;
Jang Hyo KIM
;
Seung Cheon LEE
- Publication Type:Original Article
- Keywords:
Perilunar fracture-dislocation;
Surgical treatment
- MeSH:
Arthroplasty;
Dislocations;
Early Diagnosis;
Hand Strength;
Humans;
Male;
Range of Motion, Articular;
Wrist Joint
- From:The Journal of the Korean Orthopaedic Association
1994;29(4):1192-1198
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We studied thirteen, all male, patients who had trans-scaphoid perilunar dislocation(stage I, 5 cases) and dislocation of lunate(stage IV, 8 cases). Age of patient was ranged from 25 years to 49 years(avr. 36 years)and the most common cause of injury was fall down(6 cases, 46%). Seven acute cases, diagnosed and treated within 3 weeks from injury, were treated by open reduction and K-wire fixation(5 cases), and K-wire fixation and bone graft(1 case) and Herbert screw for fracture of scaphoid(1 case). Six chronic cases diagnosed and treated after 3 weeks from injury were treated by open reduction and K-wire fixation(1 case), K-wire fixation and bone graft(1 case), removal of lunate(2 cases), and arthroplasty using muscle after removal of lunate(2 cases). Thirteen cases were followed up for average 33 months(from 13 months to 81 months). Grip power was evaluated as excellent or good in 8 cases and fair in 5 cases. Range of motion of wrist joint was decreased 21 degrees in flexion, 22 degrees in extension, 4 degrees in ulnar deviation, and 5 degrees in radial deviation of wrist joint, compared with uninjured side. Carpal height and carpal height ratio were decreased to 33.1 and 0.51, compared with normal 35.8(p=0.001) and 0.55(P < 0.001), respectively. Between 2 groups of acute and chronic cases, no significant differences were noted in carpal height or carpal height ratio. The surgical treatment of perilunar fracture-dislocation has not simple option, therefore, we would recommend the early diagnosis and exact anatomical reduction.
