title: Preliminary lunate reduction and pinning facilitates restoration of carpal height when treating perilunate dislocation, scaphoid fracture and nonunion, and scapholunate dissociation.
abstract: 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.
authors.affiliation: 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
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Tomaino
mesh_terms: 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*