Treatment of Acute and Subacute Dorsal Perilunate Fracture Dislocations

Objectives: We present the mid term results of dorsal perilunate fracture dislocations treated by open reduction and internal fixation via dorsal approach in the acute or subacute phase. Methods: In this retrospective study we evaluated 13 patients treated in two different university hospitals by two different surgeons. The mean follow up time was 20,4 months. Bilateral range of wrist motion, grip and pinch strengths were measured. We used Quick Dash-T, Mayo wrist, VAS pain and VAS satisfaction scores for subjective assessment. Union of scaphoid fracture, presence of avascular necrosis, carpal height ratio, radioscaphoid and scapholunate angles were measured for radiologic evaluation. Results: We found a 21% to 29% decrease in the range of wrist motion compared to the unaffected side. We also found an average 23% reduction in grip strength and a 20% reduction in pinch strength. Mean Quick Dash-T score was 32 and Mayo wrist score was 71. Outcomes: Results of the perilunate fracture dislocations treated in acute or subacute phase by open reduction and internal fixation via dorsal approach are satisfactory. There is a strong demand for prospective, randomized studies to compare the results of different treatment modalities.