[Perilunate dislocations and fracture-dislocations of the wrist, a review of 14 cases].
OBJECTIVE
We report a retrospective series of 14 dislocations or perilunate fracture-dislocations. The results of our series are compared with the data of the literature and we discuss epidemiology, types of lesions, surgical treatment, complications and prognosis of this pathology.


METHODS
The series included seven pure dislocations and seven fracture-dislocations including three trans-scapho-lunate forms (including one Fenton's syndrome). The displacement of all these lesions was posterior. The mean age was 35 years. Sixty-four percent were manual workers. All 14 patients had undergone surgical treatment through a dorsal approach in the first seven days following the injury. They were reviewed clinically and radiologically with a mean follow-up of 25 months.


RESULTS
The average Cooney functional score was 72/100 with two excellent, six good, four fair and two poor results. Average flexion-extension motion arc was 74%, the grip strength was 77% compared to the other wrist. Persistent wrist pain was almost constant. One carpal instability was observed and one patient required a four-corner arthrodesis for SLAC wrist. Eighty-five percent of all patients were employed at least.


CONCLUSIONS
Early diagnosis and anatomical reduction can provide satisfactory functional results. Emergency surgical treatment is required. We prefer a dorsal approach and we do not perform primary closed reductions.
Martinage
A
A
Service de chirurgie plastique, réparatrice et esthétique, chirurgie de la main, hôpital Saint-Roch, 5 rue Pierre-Dévoluy, B.P. 1319, Nice cedex 1, France. aurelienmartinage@hotmail.com
Balaguer
T
T
Chignon-Sicard
B
B
Monteil
M-C
MC
Dréant
N
N
Lebreton
E
E
D000328:Adult; D001174:Arthrodesis; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery