Cargando…

Isolated volar surgical approach for the treatment of perilunate and lunate dislocations

BACKGROUND: Volar and/or dorsal surgical approaches are used for surgical treatment of perilunate and lunate dislocations. There are no accepted approaches for treatment in the literature. We evaluated the functional results of isolated volar surgical approach for the treatment of perilunate and lun...

Descripción completa

Detalles Bibliográficos
Autores principales: Başar, Hakan, Başar, Betül, Erol, Bülent, Tetik, Cihangir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052031/
https://www.ncbi.nlm.nih.gov/pubmed/24932038
http://dx.doi.org/10.4103/0019-5413.132523
_version_ 1782320172829245440
author Başar, Hakan
Başar, Betül
Erol, Bülent
Tetik, Cihangir
author_facet Başar, Hakan
Başar, Betül
Erol, Bülent
Tetik, Cihangir
author_sort Başar, Hakan
collection PubMed
description BACKGROUND: Volar and/or dorsal surgical approaches are used for surgical treatment of perilunate and lunate dislocations. There are no accepted approaches for treatment in the literature. We evaluated the functional results of isolated volar surgical approach for the treatment of perilunate and lunate dislocation injuries. MATERIALS AND METHODS: 9 patients (6 male and 3 female patients average age 34.5 ± 3.6 years) diagnosed with perilunate or lunate dislocations between January 2000 and January 2009 were involved in the study. The reduction was performed through isolated volar surgical approach and K-wire fixation, fracture stabilization with volar ligament repair was performed. Range of wrist joint motion, fracture healing, carpal stability, grip strength, return to work were evaluated and also direct radiographs were taken routinely at each control. The scapholunate interval and the scapholunate angle were evaluated radiographically. Evaluations of the clinical results were done using the DASH, VAS and Modified Mayo Wrist Scores. RESULTS: The physical rehabilitation was started at 6(th) week, after the K-wires were removed. The average followup was 18.2 months (range 12-28 months). At the final followup, the average flexion extension arc was 105.0 ± 9.6° (74.6% of the other side), the average rotation arc was 138.8 ± 7.8° (81.5% of the other side) and the average radioulnar arc was 56.1 ± 9.9° (86.4% of the other side). The grip strength was 0.55 bar; 83.2% that the uninjured arm. According to the Mayo Modified Wrist score, the functional result was excellent in five patients and good in four and the average DASH score was 22.8. The scapholunate interval was 2.1 mm and scapholunate angle was 51°. CONCLUSION: The clinical and radiological results of the isolated volar surgical approach were satisfactory. The dorsal approach was not needed for reduction of dislocations during operations. Our results showed that an isolated volar approach was adequate.
format Online
Article
Text
id pubmed-4052031
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-40520312014-06-13 Isolated volar surgical approach for the treatment of perilunate and lunate dislocations Başar, Hakan Başar, Betül Erol, Bülent Tetik, Cihangir Indian J Orthop Original Article BACKGROUND: Volar and/or dorsal surgical approaches are used for surgical treatment of perilunate and lunate dislocations. There are no accepted approaches for treatment in the literature. We evaluated the functional results of isolated volar surgical approach for the treatment of perilunate and lunate dislocation injuries. MATERIALS AND METHODS: 9 patients (6 male and 3 female patients average age 34.5 ± 3.6 years) diagnosed with perilunate or lunate dislocations between January 2000 and January 2009 were involved in the study. The reduction was performed through isolated volar surgical approach and K-wire fixation, fracture stabilization with volar ligament repair was performed. Range of wrist joint motion, fracture healing, carpal stability, grip strength, return to work were evaluated and also direct radiographs were taken routinely at each control. The scapholunate interval and the scapholunate angle were evaluated radiographically. Evaluations of the clinical results were done using the DASH, VAS and Modified Mayo Wrist Scores. RESULTS: The physical rehabilitation was started at 6(th) week, after the K-wires were removed. The average followup was 18.2 months (range 12-28 months). At the final followup, the average flexion extension arc was 105.0 ± 9.6° (74.6% of the other side), the average rotation arc was 138.8 ± 7.8° (81.5% of the other side) and the average radioulnar arc was 56.1 ± 9.9° (86.4% of the other side). The grip strength was 0.55 bar; 83.2% that the uninjured arm. According to the Mayo Modified Wrist score, the functional result was excellent in five patients and good in four and the average DASH score was 22.8. The scapholunate interval was 2.1 mm and scapholunate angle was 51°. CONCLUSION: The clinical and radiological results of the isolated volar surgical approach were satisfactory. The dorsal approach was not needed for reduction of dislocations during operations. Our results showed that an isolated volar approach was adequate. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4052031/ /pubmed/24932038 http://dx.doi.org/10.4103/0019-5413.132523 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Başar, Hakan
Başar, Betül
Erol, Bülent
Tetik, Cihangir
Isolated volar surgical approach for the treatment of perilunate and lunate dislocations
title Isolated volar surgical approach for the treatment of perilunate and lunate dislocations
title_full Isolated volar surgical approach for the treatment of perilunate and lunate dislocations
title_fullStr Isolated volar surgical approach for the treatment of perilunate and lunate dislocations
title_full_unstemmed Isolated volar surgical approach for the treatment of perilunate and lunate dislocations
title_short Isolated volar surgical approach for the treatment of perilunate and lunate dislocations
title_sort isolated volar surgical approach for the treatment of perilunate and lunate dislocations
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052031/
https://www.ncbi.nlm.nih.gov/pubmed/24932038
http://dx.doi.org/10.4103/0019-5413.132523
work_keys_str_mv AT basarhakan isolatedvolarsurgicalapproachforthetreatmentofperilunateandlunatedislocations
AT basarbetul isolatedvolarsurgicalapproachforthetreatmentofperilunateandlunatedislocations
AT erolbulent isolatedvolarsurgicalapproachforthetreatmentofperilunateandlunatedislocations
AT tetikcihangir isolatedvolarsurgicalapproachforthetreatmentofperilunateandlunatedislocations