Results of Perilunate Dislocations and Perilunate Fracture Dislocations With a Minimum 15-Year Follow-Up.
OBJECTIVE
To evaluate the long-term clinical, functional, and radiological outcomes in 30 patients with at least 15 years of follow-up.


METHODS
We performed a retrospective study that identified 73 patients. Thirty patients agreed to participate and were included. The mean follow-up was 18 years (range, 15-24 years). There were 14 cases of perilunate dislocation and 16 cases of perilunate fracture-dislocation (including 13 transscaphoid perilunate fracture-dislocations). At the last follow-up, the clinical and functional evaluation was based on the range of motion, grip strength, the Mayo wrist score, the Quick Disabilities of the Arm Shoulder and Hand score, and the Patient-Rated Wrist Evaluation score. Radiological abnormalities, according to the Herzberg classification, were 5 type A1 cases, 7 type B, 16 type B1, and 2 type C.


RESULTS
The mean flexion-extension arc, radial-ulnar abduction arc, and pronation-supination arc were, respectively, 68%, 67%, and 80%, relative to the contralateral side. The mean grip strength was 70%, relative to the contralateral side. The mean Mayo wrist score was 70, and the mean Quick Disabilities of the Arm Shoulder and Hand and Patient-Rated Wrist Evaluation scores were, respectively, 20 and 21. Five patients had secondary procedure. Six patients had a complex regional pain syndrome type 1.


CONCLUSIONS
Although arthritis occurred in 70% of cases, its clinical and functional impact appeared to be low. However, the 2 lowest Mayo wrist scores corresponded to the patients with the most advanced arthritis. Complex regional pain syndrome appeared to have an impact on long-term outcomes.


METHODS
Therapeutic IV.
Orthopaedic Department, CHU Amiens-Picardie, Site Sud, Amiens, France. Electronic address: eliekrief1204@hotmail.fr.
Elie
E
Krief
Orthopaedic Department, CHU Amiens-Picardie, Site Sud, Amiens, France.
Benjamin
B
Appy-Fedida
Orthopaedic Department, CHU Amiens-Picardie, Site Sud, Amiens, France.
Vladimir
V
Rotari
Orthopaedic Department, CHU Amiens-Picardie, Site Sud, Amiens, France.
Emmanuel
E
David
Orthopaedic Department, CHU Amiens-Picardie, Site Sud, Amiens, France.
Patrice
P
Mertl
Orthopaedic Department, CHU Amiens-Picardie, Site Sud, Amiens, France.
Catherine
C
Maes-Clavier
D000293:Adolescent; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D018737:Hand Strength; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*
Arthritis; fracture dislocation; perilunate dislocation; wrist