Treatment of acute perilunate dislocation or fracture dislocation using dorsal approach and diamond-shaped Kirschner-wire fixation
| Autor: | Tuna Özyürekoğlu, Mehmet Ali Acar |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Wrist Joint K-wire fixation Joint Dislocations Wrist wrist instability wrist trauma Fracture Fixation Internal Fractures Bone Carpal dislocation Fracture fixation medicine Humans Orthopedics and Sports Medicine Kirschner wire Lunate Bone Retrospective Studies Orthodontics Scaphoid Bone business.industry Fracture Dislocation Rehabilitation Wrist Injuries Lunate Radiography Carpal bones medicine.anatomical_structure Outcome and Process Assessment Health Care Triquetrum Midcarpal joint lunate dislocation Surgery Original Article Female Range of motion business Bone Wires |
| Zdroj: | Joint Diseases and Related Surgery |
| ISSN: | 2687-4792 2687-4784 |
| Popis: | Objectives This study aims to evaluate the clinical and radiological outcomes of diamond-shaped Kirschner (K)-wire fixation for the treatment of acute perilunate dislocation (PLD) or trans-scaphoid perilunate fracture dislocation (PLFD). Patients and methods We performed a retrospective review of 18 patients (18 wrists; 17 males, 1 female; mean age 31.5±2.6 years; range, 18 to 47 years) treated for PLD/PLFD using a dorsal approach with the diamond-shaped K-wire fixation between November 2001 and September 2017. The mean follow-up of cohort was 27 (range, 13 to 74) months. Using a dorsal approach, open ligament repair and bone fixations were performed. Perilunate dislocation was reduced and the carpal bones and midcarpal joint were held in anatomical position using four K-wires transfixing the scapholunate (SL), lunotriquetral, scaphocapitate, and triquetrohamate joints in such a shape that each bone received two K-wires. Results The mean range of motion and grip strength measured using a Jamar® dynamometer of the injured wrist compared to the uninjured extremity were 84.3% and 78.8%, respectively. The mean Mayo wrist score was 78.3 (range, 70 to 90). The mean Visual Analog Scale score was 1.2 (range, 0 to 4). The average SL gap at the final follow-up evaluation was 1.62 (range, 1 to 2.3) mm. The mean SL and capitolunate angles were 49.3° (range, 40 to 75°) and 4.2° (range, 2 to 12°), respectively. Conclusion Because every bone is fixed with two K-wires using this configuration, a closed ring is created; hence no motion is possible between the scaphoid, capitate, hamate, triquetrum, lunate and the midcarpal joint. We believe that diamond-shaped fixation may provide reliable fixation and satisfactory clinical outcomes in patients with PLD and PLFD. |
| Databáze: | OpenAIRE |
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