Vol. 8, Issue 3 (2022)

Introduction: Perilunate injuries are rare and often caused by high-energy trauma. Despite surgical treatment, there can still be a high incidence of functional dissatisfaction and post-traumatic arthritis. The aim of this study was to evaluate the short term follow-up outcomes of perilunate dislocations (PLDs) and transscaphoid perilunate fracture dislocations (TSPLDs) treated with closed k-wire fixation without ligament repair or reconstruction.

Materials and Methods: This observational study was carried out on 12 patients diagnosed with perilunate dislocations (PLDs) and transscaphoid perilunate fracture dislocations (TSPLDs) treated with closed k-wire fixation without ligament repair or reconstruction to evaluate the short term follow-up outcomes. At the final follow-up clinical assessment was done by ROM, VAS score for pain, DASH questionnaire for Disabilities of the Arm, Shoulder and radiographs were evaluated with regard to incidence and time to scaphoid union and the lunotriquetral gap.

Results: The mean wrist movement (flexion-extension) and grip strength rates were 79.9 % and 80.2 %, respectively. The mean active flexion-extension arc was 115° (range 900 to 130°). The mean combined supination and pronation was 1650 (range 135-1800) for all injured wrists. At the final follow-up evaluation, the average SL gap was 1.4 (range, 1 to 2.7) mm. The mean SL and CL angles were 48.3° (range 40 to 75°) and 4.7° (range 2 to 12°) respectively. The mean grip strength on Jamar dynamometer was 32.9 kg. The patients achieved an average of 87% grip strength of the uninjured side. At the latest follow-up, mean post-operative VAS score for pain was 2.73 (range 0-4). The mean post-operative DASH scores was13.08 with excellent results in 7 patients.

Conclusion: The treatment of PLDs and TSPLDs with k-wire fixation without any ligament repair or reconstruction and minimum manipulation and no extra procedures can have favorable short-term subjective, objective and radiological results and minimal complications.