Management of trans-scaphoid perilunate dislocations. Herbert screw fixation, ligamentous repair and early wrist mobilization.
A retrospective review of 28 patients with 29 trans-scaphoid perilunate dislocations who underwent open reduction and Herbert screw fixation is presented. The majority of the patients had satisfactory results at 24 months of follow-up. A significantly better range of wrist motion was obtained in postoperative patients treated with cast immobilization for 4 weeks compared with those treated for longer than 5 weeks. The scaphoid fractures united well, with proper alignment of the carpal bones, regardless of the length of cast immobilization. We recommend open reduction, internal scaphoid fixation using a Herbert screw, carpal ligament repair and early cast removal in the management of trans-scaphoid perilunate dislocations.
Inoue
G
G
Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
Imaeda
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws; D002348:Carpal Bones / Q000601:surgery; D005260:Female; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007103:Immobilization; D004204:Joint Dislocations / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000150:complications / Q000601:surgery; D012189:Retrospective Studies; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*