Introduction: Perilunate dislocations are commonly seen after fall on an outstretched hand in extremes of dorsiflexion and ulnar deviation. A greater arc injury is one when there is an associated fracture of one or more bones around the lunate while a lesser arc injury is associated with pure ligamentous disruption around the lunate.
Case Report: We report a unique case of bilateral trans-scaphoid perilunate dislocation in a 35-year-old male labourer. This is the first reported case where the lunate dislocated into the forearm on the volar aspect. Urgent open reduction and stabilization of both wrists was done. Currently, the wrist is stable with functional range of motion with union of both scaphoid fractures at 1-year follow-up.
Discussion: A delay in management of perilunate dislocations is associated with unfavourable prognosis. Prompt reduction and fixation is of paramount importance. Radiocarpal arthritis is associated with delayed management. In our case, the patient has regained painless functional range of motion without any radiological evidence of arthritis.
Conclusion: We thus conclude that all perilunate dislocations must undergo emergency reduction. Open reduction and ligamentous repair should be considered as the treatment of choice as it is associated with better functional outcomes in terms of pain and arthritis.
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| http://dx.doi.org/10.1016/j.jcot.2016.04.003 | DOI Listing |
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Background: Perilunate/lunate injuries are frequently misdiagnosed. We hypothesize that utilization of a machine learning algorithm can improve human detection of perilunate/lunate dislocations.
Methods: Participants from emergency medicine, hand surgery, and radiology were asked to evaluate 30 lateral wrist radiographs for the presence of a perilunate/lunate dislocation with and without the use of a machine learning algorithm, which was used to label the lunate.
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Introduction: Perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are high-energy wrist injuries often linked to significant post-traumatic osteoarthritis. This study aims to determine whether PLD and PLFD yield different radiological outcomes following surgical treatment while identifying prognostic factors for worse outcomes.
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Article Synopsis
- Perilunate injuries, usually caused by high-impact trauma, can compress the median nerve and lead to complications if untreated, making prompt evaluation and treatment essential.
- A study reviewed 33 cases at a trauma center over nine years, noting that injuries often resulted from falls and vehicle incidents, with most cases showing some nerve issues.
- Surgical intervention was common, with 95% of patients needing surgery, and more than half requiring a carpal tunnel release, highlighting the need for personalized treatment strategies based on each case.
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