Short-term outcomes of perilunate dislocations and perilunate fracture-dislocations: a single-center retrospective study

Abstract

Background: Perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are rare, but serious wrist injuries. This study reports the radiographic and clinical outcomes of PLD/PLFD in a series of 30 patients. Methods: Thirty patients with PLD (n=4) or PLFD (n=26) and a mean follow-up of 17.2 mo (range 12 to 21) were included in this retrospective study. Radiographic outcomes included the scapholunate angle, scapholunate interval, and carpal height ratio. Clinical outcomes included the wrist range of motion (ROM), pinch, and grip strength. Wrist function was assessed by a modified Mayo wrist score. Results: At the final follow-up, the scapholunate angle and interval were above the normal value in 10 and three patients, respectively. The carpal height ratio was normal in all patients. The mean wrist flexion was 44.2±15.8 degrees. The mean wrist extension was 28.3±15.4 degrees. The mean radial deviation was 14.3±4.3 degrees. The mean ulnar deviation was 18.4±6.3 degrees. The mean grip strength was 50.4±11.6 lb. in the involved wrist and 54.6±13.3 lb. in the noninvolved wrist (P=0.27). The mean pinch strength was 9.1±2.1 lb. in the involved wrist and 9.5±1.8 lb. in the noninvolved wrist (P=0.15). The mean modified Mayo score of the patients was 65.5±10. Postoperative stiffness, pain, and carpal instability were observed in six, five, and nine patients, respectively. Conclusions: Surgical treatment of PLD/PLFD provides satisfactory radiographic outcomes. Clinical outcomes seem to be less satisfactory, even after prompt diagnosis and treatment. Level of Evidence: Level IV