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Radiological radio-carpal and mid-carpal motion after operative treatment of dorsal radio-carpal fracture dislocations

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

An Erratum to this article was published on 09 March 2012

Abstract

Purpose

Radio-carpal fracture dislocations are rare severe injuries typically seen following high energy trauma. This injury is characterized by complete dislocation of the radio-carpal joint with avulsion fracture of dorsal or palmar cortical rim of the distal radius combined with disruption of the radio-carpal ligament complex. The purpose of our study is to assess the radiological motion outcome of the radio-carpal joint after Moneim type 1 radio-carpal fracture dislocations following surgical treatment.

Patients and methods

Only Moneim type 1 injuries were included in this study. Eight patients with Moneim type 1 injuries were identified by retrospective examination of our fracture registry and included in this study. All patients were initially treated with closed reduction and plaster immobilization. CT scans were performed after reduction. Operative treatment consisted of anatomic reduction of the distal radial rim fractures and fixation with a small T-plate through a dorsal approach. Cancellous bone graft was utilized if necessary to support the articular surface. Repair of the palmar radio-carpal ligament complex was performed through a palmar wrist approach. Antero-posterior, lateral, as well as lateral flexion and extension radiographs were taken at an average follow-up of 4.1 years.

Results

Follow-up radiologic evaluation of standard lateral radiograph revealed a mean scapholunate angle of 55.6°. The mean capitolunate angle was found to be −11.6° and the mean radio-capitate angle was 10.5°. The average noted angles in maximum flexion were as follows: radiolunate 15.3°, capitolunate 18° and radiocapitate 30°. The average angles in maximum extension were: radiolunate −23.9°, capitolunate −31° and radiocapitate −55°. At follow-up, arthritic changes were assessed radiographically using the classification described by Knirk and Jupiter. Fifty-six percent of the patients were found to exhibit stage 1 traumatic arthritis, 33% had stage 2 traumatic arthritis and 11% exhibited stage 3 traumatic arthritis with radio-carpal joint space obliteration.

Conclusion

Rigid bony fixation and palmar radio-carpal ligament repair of Moneim Type 1 radio-carpal dislocations resulted in preservation of sagittal plane motion of the proximal carpal row in eight of nine cases. Our data suggest that surgical reconstruction of Moneim type 1 injuries is the preferred treatment and usually leads to satisfactory range of motion.

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References

  1. Dunn AW (1972) Fractures and dislocations of the carpus. Surg Clin North Am 52(6):1513–1538

    PubMed  CAS  Google Scholar 

  2. Fernandez DL, Ghillani R (1987) External fixation of complex carpal dislocations: a preliminary report. J Hand Surg [Am] 12(3):335–347

    CAS  Google Scholar 

  3. Kaufmann RA, Pfaeffle HJ, Blankenhorn BD, Stabile K, Robertson D, Goitz R (2006) Kinematics of the midcarpal and radio-carpal joint in flexion and extension: an in vitro study. J Hand Surg [Am] 31(7):1142–1148. doi:10.1016/j.jhsa.2006.05.002

    Article  Google Scholar 

  4. Lutz M, Rudisch A, Kralinger F, Smekal V, Goebel G, Gabl M, Pechlaner S (2005) Sagittal wrist motion of carpal bones following intraarticular fractures of the distal radius. J Hand Surg [Br] 30(3):282–287. doi:10.1016/j.jhsb.2004.12.012

    Article  CAS  Google Scholar 

  5. Knirk JL, Jupiter JB (1986) Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am 68(5):647–659

    PubMed  CAS  Google Scholar 

  6. Garcia-Elias M, An KN, Amadio PC, Cooney WP, Linscheid RL (1989) Reliability of carpal angle determinations. J Hand Surg [Am] 14(6):1017–1021

    Article  CAS  Google Scholar 

  7. Gabl M, Lutz M, Pechlaner S, Fink C (1996) Perilunate dislocation and dislocation fractures—results of surgical management. Unfallchirurg 99(9):650–655. doi:10.1007/s001130050038

    Article  PubMed  CAS  Google Scholar 

  8. Herzberg G, Forissier D (2002) Acute dorsal trans-scaphoid perilunate fracture-dislocations: medium-term results. J Hand Surg [Br] 27(6):498–502. doi:10.1054/jhsb.2002.0774

    Article  CAS  Google Scholar 

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

    PubMed  Google Scholar 

  10. Moneim MS, Bolger JT, Omer GE (1985) Radio-carpal dislocation—classification and rationale for management. Clin Orthop Relat Res 192:199–209

    PubMed  Google Scholar 

  11. Ilyas AM, Mudgal CS (2008) Radio-carpal fracture-dislocations. J Am Acad Orthop Surg 16(11):647–655

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Trauma Surgery and Sports Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Jürgen Oberladstätter, Rohit Arora, Christian Dallapozza, Vinzenz Smekal, Christian Kammerlander & Martin Lutz

Authors
  1. Jürgen Oberladstätter
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  2. Rohit Arora
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  3. Christian Dallapozza
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  4. Vinzenz Smekal
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  5. Christian Kammerlander
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  6. Martin Lutz
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Corresponding author

Correspondence to Jürgen Oberladstätter.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00402-012-1492-9

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Oberladstätter, J., Arora, R., Dallapozza, C. et al. Radiological radio-carpal and mid-carpal motion after operative treatment of dorsal radio-carpal fracture dislocations. Arch Orthop Trauma Surg 130, 77–81 (2010). https://doi.org/10.1007/s00402-009-0902-0

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  • DOI: https://doi.org/10.1007/s00402-009-0902-0

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