[Carpal perilunar dislocation. Clinical study (apropos of 39 cases)]


Published online: Sep 27 1993

T Fikry, A Lamine, A Harfaoui, M Dkhissi, B Essadki, B Zryouil, and M Trafeh.

Service de Chirurgie Orthopédique et Réparatrice Aile 4, Casablanca, Maroc.

Abstract

Carpal perilunar dislocations are hidden lesions with uncertain outcome and treatment which is not yet standardized. This retrospective study including 39 cases of carpal perilunar dislocations helps clarify these issues. For fresh dislocations, the diagnosis was established in 66%. Surgical treatment was performed in 26 cases. Anatomic results showed nonunion, necrosis and residual instability. Function was always decreased and was worse in open forms or after orthopedic treatment. Scaphoid screwing results were better than those from pinning. Lateral wrist x rays must always be ordered in cases of wrist trauma to avoid delayed diagnosis. Surgical treatment must systematically use a palmar incision; it permits precise repair of bones and ligamentous lesions and reduces the risk of arthritis.