A Comparison of Outcomes in Acute Perilunate Injuries: Systematic Review and Meta-Analysis of Treatment Approaches.

Autor:	Abola MV; Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA., Gerber BA; Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA., Rocks MC; George Washington University School of Medicine & Health Sciences, Washington, DC, USA., Chen JS; Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA., Hacquebord JH; Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.; Hansjorg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA., Azad A; Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Hand (New York, N.Y.) [Hand (N Y)] 2024 Feb 28, pp. 15589447241231291. Date of Electronic Publication: 2024 Feb 28.
DOI:	10.1177/15589447241231291
Abstrakt:	Background: Perilunate dislocations (PLD) and fracture-dislocations (PLFD) comprise a spectrum of high-energy wrist injuries. The purpose of this review was to review operative strategies for perilunate injuries based on approach and compare outcomes. Methods: A systematic review of literature on PLD and fracture-dislocations was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed and EMBASE databases were queried for literature. Inclusion criteria included English studies reporting clinical or functional outcomes of acute PLD and PLFD. Results: Twenty-nine full-text articles (604 PLD and PLFD injuries) were included. The most common method of PLD and PLFD fixation is through an open approach with combined volar and dorsal exposure. There were no differences between approaches with regard to total arc range of motion, grip strength, Mayo Wrist Score, or mean scapholunate angle. Similarly, there was no difference between approaches and postoperative radiographic arthritis or complications. Most patients were able to return to their prior level of function and work. The incidence of postoperative complications ranged from 0% to 22.5%. Conclusion: Current evidence shows no difference in postoperative total wrist arc range of motion, grip strength (as compared to contralateral), or Mayo Wrist Score with regard to surgical approach. The most common method of PLD and PLFD fixation in the literature is through an open approach with combined volar and dorsal exposure. There is a large difference in reported rates of radiographic arthritis, although this finding does not appear to correlate with postoperative pain or disability. Level of Evidence: I, Systematic Review. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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