title: Percutaneous screw and axial Kirschner wire fixation for acute transscaphoid perilunate fracture dislocation.
abstract: OBJECTIVE
  In this retrospective, nonrandomized study, we evaluated the clinical outcomes of percutaneous screw and K-wire fixation in the treatment of acute transscaphoid perilunate fracture dislocation.
  
  
  METHODS
  Between 2004 and 2009, we studied 24 patients treated by fixation with a 2.0-mm (0.078-in) axial K-wire across the capitolunate joint and a percutaneous screw (3.0-mm AO cannulated screws were used in 13 patients, and Herbert-Whipple screws were used in 11 patients) within 7 days of the injury. We performed a comparative radiographic assessment of the scapholunate angle, radiolunate angle, capitolunate angle, revised carpal height ratio, and gap between the scapholunate joint between the injured wrist and the contralateral, healthy wrist. Clinical outcomes were evaluated on the basis of range of motion, pain, functional status, and Mayo scores.
  
  
  RESULTS
  Twenty-three patients (96%) achieved scaphoid union at a mean union time of 18 weeks (range, 14-28 wk). Radiographic assessments revealed no statistically significant difference between the injured wrist and the contralateral, healthy wrist. However, significant differences were noted in the mean range of motion during flexion and forearm supination between the injured wrist and contralateral healthy wrist. The mean wrist function results were encouraging, and the average Mayo score was 83.
  
  
  CONCLUSIONS
  A percutaneous procedure involving screw fixation for the scaphoid fracture and an axial K-wire fixation for intercarpal dislocation is a successful treatment for acute transscaphoid perilunate fracture dislocation.
  
  
  METHODS
  Prognostic III.
authors.affiliation: Department of Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. enjoycu@ms22.hinet.net
authors.forename: Ying-Chao
authors.initials: YC
authors.lastname: Chou
authors.forename: Yung-Heng
authors.initials: YH
authors.lastname: Hsu
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Cheng
authors.forename: Chi-Chuan
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000328:Adult; D001863:Bone Screws; D001864:Bone Wires; D002370:Casts, Surgical; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery*; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D021361:Scaphoid Bone; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000601:surgery*; D055815:Young Adult