CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2021; 49(01): 013-018
DOI: 10.1055/s-0041-1729999
Artículo original | Original article

Perilunate Lesions – Clinical and Radiological Results with a Minimum of 2 Years of Follow-up

Article in several languages: English | español
Elisabete Ribeiro
1  Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Nuno Oliveira
1  Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Juvenália Ribeiro
1  Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Pedro Varanda
1  Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
,
Luis Filipe Rodrigues
1  Department of Orthopaedic Surgery and Trauma, Hospital de Braga, Braga, Portugal
› Author Affiliations

Abstract

Perilunate injuries are complex and rare lesions with circumferential carpal bones, ligamentous and cartilage involvement. Despite optimal surgical treatment, poor prognosis is expected and usually gets worse over time. Our aim was to address clinical and radiological outcomes after 2 years of follow-up. Seven wrists were revised with average age of 35.59 ± 14.01 (range 21–56) years old and mean follow-up of 44.10 ± 14.24 (range 25.60–68.63) months. At the latest follow-up, mean postoperative VAS score for pain was 2.71 ± 3.40 and DASH score was 10.48 ± 10.54. Patients returned to work in 5.00 ± 3.15 months. Strength and Range of Motion (ROM) parameters were ∼80% of the contralateral side, with exception for extension (61%) and radial deviation (73%). After 2 years of follow-up, radiographic arthrosis was observed in 29% of the cases. One of these patients was symptomatic and was proposed for arthrodesis. Mean carpal height was 1.51 ± 0.81 and scapholunate angle was 41.58 ± 22.82°. A correlation was observed between arthritis found at final follow-up and grip (r=−0.8660; p < 0.001) and pinch strength (r=−0.8885; p < 0.001). In conclusion, despite characteristic guarded prognosis, efforts to perform a prompt and adequate treatment are helpful. Clinical and radiological outcomes may not be related. Thus, it is of main importance to understand patients' perception of their sequelae.

Disclosures

All the authors state no conflicts of interest.




Publication History

Received: 31 May 2020

Accepted: 09 December 2020

Publication Date:
02 July 2021 (online)

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