title: Acute Proximal Row Carpectomy after Complex Carpal Fracture Dislocation.
abstract: Acute proximal row carpectomy is an uncommon definitive treatment for perilunate fracture dislocations. In this report, we present five patients who had acute proximal row carpectomy (PRC) to treat perilunate fracture-dislocations. All patients were men between ages 31 and 87. The indication for PRC was lunate fracture in two patients, concomitant displaced scaphoid fracture and scapholunate ligament injury in two patients, and perilunate fracture-dislocation with preexisting articular damage from long-standing gout in one patient. At the final follow-up ranged from 4.5 month to 7.5 years, four patients had no pain and one patient was lost to follow-up. One patient had a concomitant PRC and a bridging plate that was never removed. The remaining three patients gained satisfactory range of motion. Our observation reveals that acute proximal row carpectomy is an option for some patients with complex carpal fracture dislocations, particularly those with fracture of the lunate, concomitant scaphoid fracture and scapholunate ligament injury, or preexisting wrist arthritis.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Russchen
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA.
authors.forename: Amir Reza
authors.initials: AR
authors.lastname: Kachooei
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA.
authors.forename: Teun
authors.initials: T
authors.lastname: Teunis
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, 55 Fruit Street, Suite 2100, Boston, MA 02114 USA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
keywords: Acute; Perilunate fracture dislocation; Proximal row carpectomy; Scapholunate ligament; Trauma; Wrist arthritis