PDF herunterladen
J Wrist Surg 2019; 08(06): 508-512
DOI: 10.1055/s-0039-1677743
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reduction and Association of the Lunotriquetral Ligament for Reverse Perilunate Dislocation

Hui-Kuang Huang
1   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
2   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
3   Department of Orthopaedics, Chiayi Christian Hospital, Chiayi, Taiwan
4   Department of Food nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan
,
Tung-Yeh Tsai
5   Division of Orthopaedics, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
,
Jung-Pan Wang
1   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
2   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
› Institutsangaben
Weitere Informationen

Publikationsverlauf

29. Oktober 2018

26. Dezember 2018

Publikationsdatum:
27. Februar 2019 (online)

    Lizenzen und Reprints

Abstract

Background Reverse perilunate injuries are rare. Contrary to perilunate injuries, the violent force would start from the lunotriquetral ligament, go reversely toward the radial side, and cause the reverse or ulnar-sided perilunate dislocation.

Case Description We describe a 31-year-old man with a reverse perilunate dislocation, who presented to our institution 3 weeks after a motorcycle accident. The patient was successfully treated with the reduction and association of the lunate and triquetrum (RALT) procedure by using closed maneuver and percutaneous headless compression screw fixation. The patient can obtain a good radiographic result and satisfactory function at the 30-month follow-up.

Literature Review Many case series were reported concerning the perilunate injuries. However, few cases of reverse perilunate dislocation have been reported in the literature. No cases of reverse perilunate dislocation treated 3 weeks after the injury with the RALT procedure have been reported.

Clinical Relevance In this case, we found that the dislocation could still be reduced with the closed maneuver. With the RALT procedure, the carpal alignment can be maintained and the stability can be regained. Also, the functional outcomes are good.

Keywords

carpal dislocation - lunotriquetral ligament - RALT - perilunate - reverse

Note

The work was performed in Taipei Veterans General Hospital, Taipei, Taiwan.


 

  • References

  • 1 Mayfield JK, Johnson RP, Kilcoyne RK. Carpal dislocations: pathomechanics and progressive perilunar instability. J Hand Surg Am 1980; 5 (03) 226-241
    CrossrefPubMedGoogle Scholar
  • 2 Viegas SF, Patterson RM, Peterson PD. , et al. Ulnar-sided perilunate instability: an anatomic and biomechanic study. J Hand Surg Am 1990; 15 (02) 268-278
    PubMedGoogle Scholar
  • 3 van Leeuwen DH, Buijze GA, Ring D. Ulnar to radial dorsal fracture-dislocations of the wrist: a report of 2 cases. J Hand Surg Am 2012; 37 (03) 500-502.e1
    CrossrefPubMedGoogle Scholar
  • 4 Atkinson CT, Watson J. Lunotriquetral ligament tears. J Hand Surg Am 2012; 37 (10) 2142-2144
    CrossrefPubMedGoogle Scholar
  • 5 Murray PM, Palmer CG, Shin AY. The mechanism of ulnar-sided perilunate instability of the wrist: a cadaveric study and 6 clinical cases. J Hand Surg Am 2012; 37 (04) 721-728
    CrossrefPubMedGoogle Scholar
  • 6 Chin A, Garcia-Elias M. Combined reverse perilunate and axial-ulnar dislocation of the wrist: a case report. J Hand Surg Eur Vol 2008; 33 (05) 672-676
    CrossrefPubMedGoogle Scholar
  • 7 Leung YF, Ip SP, Wong A, Ip WY. Trans-triquetral dorsal perilunate fracture dislocation. J Hand Surg Eur Vol 2007; 32 (06) 647-648
    CrossrefPubMedGoogle Scholar
  • 8 Khurana S, Chen Z, Dowdle J. Perihamate-peripisiform-transtriquetrum axial ulnar fracture dislocation of the hand with an associated perilunate Injury. J Hand Surg Am 2018; 43 (03) 292.e1-292.e6
    CrossrefPubMedGoogle Scholar
  • 9 Koehler SM, Guerra SM, Kim JM, Sakamoto S, Lovy AJ, Hausman MR. Outcome of arthroscopic reduction association of the scapholunate joint. J Hand Surg Eur Vol 2016; 41 (01) 48-55
    CrossrefPubMedGoogle Scholar
  • 10 Palmer AK, Werner FW. The triangular fibrocartilage complex of the wrist--anatomy and function. J Hand Surg Am 1981; 6 (02) 153-162
    CrossrefPubMedGoogle Scholar