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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2021; 49(01): 013-018
DOI: 10.1055/s-0041-1729999
Artículo original | Original article

Perilunate Lesions – Clinical and Radiological Results with a Minimum of 2 Years of Follow-up

Artikel in mehreren Sprachen: English | español
Elisabete Ribeiro
1   Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Nuno Oliveira
1   Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Juvenália Ribeiro
1   Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Pedro Varanda
1   Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Luis Filipe Rodrigues
1   Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
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Abstract

Perilunate injuries are complex and rare lesions with circumferential carpal bones, ligamentous and cartilage involvement. Despite optimal surgical treatment, poor prognosis is expected and usually gets worse over time. Our aim was to address clinical and radiological outcomes after 2 years of follow-up. Seven wrists were revised with average age of 35.59 ± 14.01 (range 21–56) years old and mean follow-up of 44.10 ± 14.24 (range 25.60–68.63) months. At the latest follow-up, mean postoperative VAS score for pain was 2.71 ± 3.40 and DASH score was 10.48 ± 10.54. Patients returned to work in 5.00 ± 3.15 months. Strength and Range of Motion (ROM) parameters were ∼80% of the contralateral side, with exception for extension (61%) and radial deviation (73%). After 2 years of follow-up, radiographic arthrosis was observed in 29% of the cases. One of these patients was symptomatic and was proposed for arthrodesis. Mean carpal height was 1.51 ± 0.81 and scapholunate angle was 41.58 ± 22.82°. A correlation was observed between arthritis found at final follow-up and grip (r = −0.8660; p < 0.001) and pinch strength (r = −0.8885; p < 0.001). In conclusion, despite characteristic guarded prognosis, efforts to perform a prompt and adequate treatment are helpful. Clinical and radiological outcomes may not be related. Thus, it is of main importance to understand patients' perception of their sequelae.

Keywords

dislocation - fracture-dislocation - arthritis

Disclosures

All the authors state no conflicts of interest.




Publikationsverlauf

Eingereicht: 31. Mai 2020

Angenommen: 09. Dezember 2020

Artikel online veröffentlicht:
02. Juli 2021

© 2021. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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