Purpose
Perilunate dislocations and transscaphoid perilunate fracture dislocations are associated
with a high incidence of posttraumatic arthritis. According to the current literature,
at medium-term follow-up, radiological signs of arthritis do not correlate with functional
scores. The aim of this study was to evaluate patient hand function and the development
of posttraumatic arthritis after perilunate dislocations (11 cases) and transscaphoid
perilunate fracture dislocations (7 cases) at a minimum 10 years of follow-up.
Methods
A retrospective review was performed including 18 patients with a minimum 10-year
(average, 13 y) follow-up. The clinical results were evaluated using the Mayo wrist
score and the patient-rated wrist evaluation. Radiological abnormalities were stratified
using the Herzberg classification.
Results
According to the Mayo wrist score, the authors found 5 excellent, 3 good, 7 fair,
and 3 poor results. The mean Mayo wrist score was 76 (range, 60–90). There were 6
type A, 5 type A1, 6 type B1, and 1 type C, according to the Herzberg classification.
Posttraumatic degenerative changes were observed in 12 cases.
Conclusions
The presence of radiological arthritis and static carpal instability did not cause
reduced function at our minimum follow-up of 10 years. Based on our findings and previously
reported series, we conclude that signs of posttraumatic arthritis after perilunate
dislocations and transscaphoid perilunate fracture dislocations increase progressively
but are well tolerated at an average follow-up of 13 years.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: November 23, 2009
Accepted:
September 3,
2009
Received:
February 25,
2009
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2010 Published by Elsevier Inc.
