International Orthopaedics

, Volume 34, Issue 8, pp 1315–1320 | Cite as

Chronic perilunate dislocations treated with open reduction and internal fixation: results of medium-term follow-up

  • Liang Kailu
  • Xiang Zhou
  • Huang FuguoEmail author
Original Paper


The purpose of this study was to evaluate the medium-term follow-up results of a series of ten perilunate dislocations treated operatively at least three weeks following injury. The intervals from injury to treatment of the delayed and the chronic groups were four weeks (range, three to six weeks) and 17 weeks (range, 11–25 weeks), respectively. The average follow-up time was 90 months. Surgical procedures included open reduction, internal fixation, grafting, ligament repair, and external fixation. Clinical function was evaluated by the Cooney clinical scoring system. The radiological assessment included the radiolunate angle, scapholunate angle, the revised carpal height ratio, and presence or absence of midcarpal arthritis. In the delayed group, there were two excellent, one good and one poor results. The average postoperative clinical score was 81 (good). In the chronic group, there were four good, one fair, and one poor results. At the last follow-up, the average postoperative clinical score was 76.7 (good). Our results indicate that open reduction and internal fixation can be applied in the treatment of delayed and some of the chronic perilunate dislocations and achieve satisfactory results.


Open Reduction Scaphoid Fracture Chronic Group Interosseous Ligament Midcarpal Joint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Herzberg G, Comtet JJ, Linscheid RL, Amadio PC, Cooney WP, Stalder J (1993) Perilunate dislocations and fracture dislocations: a multicenter study. J Hand Surg Am 18(5):768–779PubMedCrossRefGoogle Scholar
  2. 2.
    Inoue G, Imaeda T (1997) Management of trans-scaphoid perilunate dislocations. Herbert screw fixation, ligamentous repair and early wrist mobilization. Arch Orthop Trauma Surg 116(6–7):338–340PubMedCrossRefGoogle Scholar
  3. 3.
    Green DP, O’Brien ET (1978) Open reduction of carpal dislocations: indications and operative techniques. J Hand Surg Am 3(3):250–265PubMedGoogle Scholar
  4. 4.
    Wagner CJ (1956) Perilunar dislocations. J Bone Joint Surg Am 38-A(6):1198–1207PubMedGoogle Scholar
  5. 5.
    Campbell RD Jr, Lance EM, Yeoh CB (1964) Lunate and perilunar dislocations. J Bone Joint Surg Br 46:55–72PubMedGoogle Scholar
  6. 6.
    MacAusland WR (1944) Perilunar dislocation of the carpal bones and dislocation of the lunate bone. Surg Gynecol Obstet 79:256–259Google Scholar
  7. 7.
    Inoue G, Shionoya K (1999) Late treatment of unreduced perilunate dislocations. J Hand Surg Br 24(2):221–225PubMedCrossRefGoogle Scholar
  8. 8.
    Fisk GR (1984) The wrist. J Bone Joint Surg Br 66(3):396–407PubMedGoogle Scholar
  9. 9.
    Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 214:136–147PubMedGoogle Scholar
  10. 10.
    Siegert JJ, Frassica FJ, Amadio PC (1988) Treatment of chronic perilunate dislocations. J Hand Surg Am 13(2):206–212PubMedCrossRefGoogle Scholar
  11. 11.
    Komurcu M, Kürklü M, Ozturan KE, Mahirogullari M, Basbozkurt M (2008) Early and delayed treatment of dorsal transscaphoid perilunate fracture–dislocations. J Orthop Trauma 22(8):535–540PubMedCrossRefGoogle Scholar
  12. 12.
    Takami H, Takahashi S, Ando M, Masuda A (1996) Open reduction of chronic lunate and perilunate dislocations. Arch Orthop Trauma Surg 115(2):104–107PubMedCrossRefGoogle Scholar
  13. 13.
    Weir IG (1992) The late reduction of carpal dislocations. J Hand Surg Br 17(2):137–139PubMedCrossRefGoogle Scholar
  14. 14.
    Brittberg M, Winalski CS (2003) Evaluation of cartilage injuries and repair. J Bone Jt Surg Am 85-A(Suppl 2):58–69Google Scholar
  15. 15.
    Hildebrand KA, Ross DC, Patterson SD, Roth JH, MacDermid JC, King GJ (2000) Dorsal perilunate dislocations and fracture-dislocations: questionnaire, clinical, and radiographic evaluation. J Hand Surg Am 5:1069–1079Google Scholar
  16. 16.
    Geissler WB, Freeland AE, Savoie FH, McIntyre LW, Whipple TL (1996) Intracarpal soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg Am 78:357–365PubMedGoogle Scholar
  17. 17.
    Nattrass GR, King GJ, McMurtry RY, Brant RF (1994) An alternative method for determination of the carpal height ratio. J Bone Joint Surg Am 76(1):88–94PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Orthopaedic Department, West China HospitalSichuan UniversityChengduPeople’s Republic of China

Personalised recommendations