Preliminary lunate reduction and pinning facilitates restoration of carpal height when treating perilunate dislocation, scaphoid fracture and nonunion, and scapholunate dissociation.
Carpal collapse potentially accompanies greater and lesser arc perilunate injuries; unstable, acute scaphoid fracture; scaphoid nonunion with humpback deformity; and scapholunate dissociation. When surgical treatment is elected, preliminary reduction of the lunate from extension to neutral--to correct dorsal intercalated segment instability deformity--facilitates restoration of carpal height and decreases the risk of carpal malalignment and scapholunate advanced-collapse arthritis. This simple technique is described.
Tomaino
Matthew M
MM
Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, New York 14642, USA. Matthew_Tomaino@URMC.Rochester.edu
D001858:Bone Nails; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000517:prevention & control; D012667:Lunate Bone / Q000293:injuries / Q000601:surgery; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D018570:Risk Assessment; D021361:Scaphoid Bone / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*