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Management of trans-scaphoid perilunate dislocations

Herbert screw fixation, ligamentous repair and early wrist mobilization

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Abstract

A retrospective review of 28 patients with 29 trans-scaphoid perilunate dislocations who underwent open reduction and Herbert screw fixation is presented. The majority of the patients had satisfactory results at 24 months of follow-up. A significantly better range of wrist motion was obtained in postoperative patients treated with cast immobilization for 4 weeks compared with those treated for longer than 5 weeks. The scaphoid fractures united well, with proper alignment of the carpal bones, regardless of the length of cast immobilization. We recommend open reduction, internal scaphoid fixation using a Herbert screw, carpal ligament repair and early cast removal in the management of trans-scaphoid perilunate dislocations.

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References

  1. 1.

    Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop 214:136–147

  2. 2.

    Green D, O'Brien ET (1978) Open reduction of carpal dislocations. Indications and operative techniques. J Hand Surg 3:250–265

  3. 3.

    Herbert TJ, Fisher WE (1984) Management of the fractured scaphoid using a new bone screw. J Bone Joint Surg [Br] 66:114–124

  4. 4.

    Howard FM, Dell PC (1986) The unreduced carpal dislocation: a method of treatment. Clin Orthop 202: 112–116

  5. 5.

    Inoue G, Tanaka Y, Nakamura R (1990) Treatment of transscaphoid perilunate dislocations by internal fixation with the Herbert screw. J Hand Surg [Br] 15:449–454

  6. 6.

    Moneim MS, Hofammann KE, Omer GE (1984) Transscaphoid perilunate fracture-dislocation. Result of open reduction and pin fixation. Clin Orthop 190:227–235

  7. 7.

    Siegert JJ, Frassica FJ, Amadio RA (1988) Treatment of chronic perilunate dislocation. J Hand Surg [Am] 13:206–212

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Author information

Correspondence to G. Inoue.

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Inoue, G., Imaeda, T. Management of trans-scaphoid perilunate dislocations. Arch Orthop Trauma Surg 116, 338–340 (1997). https://doi.org/10.1007/BF00433985

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Keywords

  • Immobilization
  • Satisfactory Result
  • Retrospective Review
  • Open Reduction
  • Screw Fixation