[Four bone versus capito-lunate limited carpal fusion. Report of 40 cases].

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Abstract

[Indexed for MEDLINE] 18. Chir Main. 2008 Feb;27(1):31-9. doi: 10.1016/j.main.2007.10.006. Epub 2007 Nov 20. [Perilunate dislocations and fracture-dislocations of the wrist, a review of 14 cases]. [Article in French] Martinage A(1), Balaguer T, Chignon-Sicard B, Monteil MC, Dréant N, Lebreton E. Author information: (1)Service de chirurgie plastique, réparatrice et esthétique, chirurgie de la main, hôpital Saint-Roch, 5 rue Pierre-Dévoluy, B.P. 1319, Nice cedex 1, France. aurelienmartinage@hotmail.com OBJECTIVES: We report a retrospective series of 14 dislocations or perilunate fracture-dislocations. The results of our series are compared with the data of the literature and we discuss epidemiology, types of lesions, surgical treatment, complications and prognosis of this pathology. METHODS: The series included seven pure dislocations and seven fracture-dislocations including three trans-scapho-lunate forms (including one Fenton's syndrome). The displacement of all these lesions was posterior. The mean age was 35 years. Sixty-four percent were manual workers. All 14 patients had undergone surgical treatment through a dorsal approach in the first seven days following the injury. They were reviewed clinically and radiologically with a mean follow-up of 25 months. RESULTS: The average Cooney functional score was 72/100 with two excellent, six good, four fair and two poor results. Average flexion-extension motion arc was 74%, the grip strength was 77% compared to the other wrist. Persistent wrist pain was almost constant. One carpal instability was observed and one patient required a four-corner arthrodesis for SLAC wrist. Eighty-five percent of all patients were employed at least. CONCLUSIONS: Early diagnosis and anatomical reduction can provide satisfactory functional results. Emergency surgical treatment is required. We prefer a dorsal approach and we do not perform primary closed reductions. DOI: 10.1016/j.main.2007.10.006