Perilunate Dislocations and Fracture-Dislocations: A Retrospective Study of 11 Cases

Abstract

Perilunate dislocations (PD) and perilunate fracture-dislocations (PFD) of the carpus are rare but important entity in so far as it presents a high risk of after-effects and post-traumatic osteoarthritis. We report a retrospective, monocentric and multioperator series of 11 patients with a mean follow-up of 24 months over a -year period from 2016 to 2020. The objective of our study was to establish an epidemiological profile and to study the clinical, functional and radiological results of PD and PFD of the carpus while underlining the interest of early management. There were 3 pure PDs and 8 trans-scaphoid PFDs with 10 dorsally displaced forms and only one ventrally displaced form. Clinical and functional evaluation was based on mobilities, strength, pain, Cooney Score, Quick-DASH, and PRWE. Radiological abnormalities were analyzed with the Herzberg classification. All patients were treated surgically after closed reduction, with a dorsal approach in 3 cases, and a palmar approach in 8 patients. Early diagnosis and anatomical reduction provide a satisfactory functional result to avoid complications. This implies an emergency open surgical treatment, a close follow-up and a postoperative rehabilitation in the shortest possible time.