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Cievet M, Buffard M, Kumble A, Ramos-Pascual S, Locquet V, Burnier M. Outcomes of arthroscopic versus open reduction and internal fixation for the treatment of acute traumatic lunate fractures: a systematic review. HAND SURGERY & REHABILITATION 2023:S2468-1229(23)00114-7. [PMID: 37364729 DOI: 10.1016/j.hansur.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023]
Abstract
The purpose of the study was to compare outcomes of fully-arthroscopic reduction and internal fixation (ARIF) versus open reduction and internal fixation (ORIF) to treat acute traumatic lunate fractures. A literature search was conducted using Medline and Embase. Demographic data and outcomes were extracted for included studies. The search identified 2,146 references: 17 articles were included, reporting on 20 cases (4 ARIF and 16 ORIF). No differences between ARIF and ORIF were found in rate of union (100% vs 93%, P = 1.000), grip strength (mean difference, 8%; 95%CI, -16-31; P = 0.592), rate of return to work (100% vs 100%, P = 1.000), or range of motion (mean difference, 28°; 95%CI, -25-80; P = 0.426). Lunate fractures were not identified in 6 of the 19 radiographs, but were identified in all CT scans. There were no differences in outcome between ARIF and ORIF for the treatment of fresh lunate fracture. The authors recommend surgeons to perform CT scans when diagnosing high-energy wrist trauma so as not to overlook lunate fractures. LEVEL OF EVIDENCE: Level IV.
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Affiliation(s)
- Maxime Cievet
- Institut Chirurgical de la Main et du Membre Supérieur, 17 Avenue Condorcet, 69100, Villeurbanne, France; Clinique Trenel, 575 Rue du Dr Trenel, 69560, Sainte-Colombe, France.
| | - Marius Buffard
- Institut Chirurgical de la Main et du Membre Supérieur, 17 Avenue Condorcet, 69100, Villeurbanne, France; Hôpital Edouard Herriot, CHU Lyon, Service de Chirurgie Orthopédique Main et Membre Supérieur, 5 Place d'Arsonval, 69003, Lyon, France.
| | - Ankitha Kumble
- Hôpital Edouard Herriot, CHU Lyon, Service de Chirurgie Orthopédique Main et Membre Supérieur, 5 Place d'Arsonval, 69003, Lyon, France.
| | - Sonia Ramos-Pascual
- Hôpital Edouard Herriot, CHU Lyon, Service de Chirurgie Orthopédique Main et Membre Supérieur, 5 Place d'Arsonval, 69003, Lyon, France.
| | - Vincent Locquet
- Institut Chirurgical de la Main et du Membre Supérieur, 17 Avenue Condorcet, 69100, Villeurbanne, France.
| | - Marion Burnier
- Institut Chirurgical de la Main et du Membre Supérieur, 17 Avenue Condorcet, 69100, Villeurbanne, France.
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Herzberg G, Cievet-Bonfils M, Burnier M. Arthroscopic Treatment of Translunate Perilunate Injuries, Not Dislocated (PLIND). J Wrist Surg 2019; 8:143-146. [PMID: 30941255 PMCID: PMC6443390 DOI: 10.1055/s-0038-1667307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/26/2018] [Indexed: 10/28/2022]
Abstract
Background Translunate perilunate dislocations were recently described as well as perilunate injuries, not dislocated (PLIND). The authors present a case of transradial styloid, translunate PLIND which sustained a full arthroscopic reduction and internal fixation. Case Description A 33-year-old man sustained a transradial styloid, translunate PLIND due to a fall from a truck with his wrist in hyperextension. The diagnosis was made at the acute stage. Full arthroscopic reduction and internal fixation with Kirschner wires was performed, followed by a 6 weeks' immobilization period. Uneventful healing of both the lunate and radial styloid were observed at 6 weeks and confirmed with a computed tomography scan. At 4 years of follow-up, the Lyon wrist score was 78% (good). Literature Review Very few lunate fractures are described in the literature. Translunate perilunate dislocations were recently described as well as PLIND. To the best of the authors' knowledge, a case of transradial styloid, translunate PLIND which sustained a full arthroscopic reduction and internal fixation has never been reported so far. Clinical Relevance This case reports a unique pattern of transradial styloid, translunate PLIND and outlines the usefulness of a full arthroscopic treatment. An open reduction for this pattern of injury would have been extensive, difficult, and probably unreliable.
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Affiliation(s)
- Guillaume Herzberg
- Wrist Surgery Unit, Department of Orthopaedics, Claude-Bernard Lyon 1 University, Herriot Hospital, Lyon, France
| | - Maxime Cievet-Bonfils
- Wrist Surgery Unit, Department of Orthopaedics, Claude-Bernard Lyon 1 University, Herriot Hospital, Lyon, France
| | - Marion Burnier
- Wrist Surgery Unit, Department of Orthopaedics, Claude-Bernard Lyon 1 University, Herriot Hospital, Lyon, France
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Shunmugam M, Phadnis J, Watts A, Bain GI. Lunate fractures and associated radiocarpal and midcarpal instabilities: a systematic review. J Hand Surg Eur Vol 2018; 43:84-92. [PMID: 29132239 DOI: 10.1177/1753193417740850] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of this study was to analyse lunate fractures and any associated osseo-ligamentous injuries. A systematic review identified 34 cases. We identified carpal instabilities at the radiocarpal and midcarpal joints in volar and dorsal directions. Radiocarpal instabilities (10/34) were usually dorsoradial (8/10), with a transverse lunate fracture, best seen on a coronal image. Midcarpal instabilities (24/34) were usually volar (14/18), with a volar lunate shear fracture, best seen on a sagittal image. Instabilities were sub-classified into non-displaced, subluxated and dislocated. Associated fractures of the scaphoid and the radial and ulnar styloid processes were common. Lunate fractures without subluxation or dislocation had good outcomes with cast immobilization or fixation of associated fractures. Lunate fracture-subluxations are unstable injuries that are best managed with fixation of the carpal fractures. Lunate fracture-dislocations are complex injuries, requiring stabilization of the lunate, associated fractures and ligament injuries; complications are common and acute or delayed salvage procedures may be required.
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Affiliation(s)
- Meenalochani Shunmugam
- 1 Flinders University, Adelaide, Australia.,2 Department of Orthopaedic Surgery and Trauma, Flinders Medical Centre, Adelaide, Australia
| | - Joideep Phadnis
- 1 Flinders University, Adelaide, Australia.,2 Department of Orthopaedic Surgery and Trauma, Flinders Medical Centre, Adelaide, Australia.,3 Department of Trauma and Orthopaedics, Brighton and Sussex University Hospitals, UK
| | - Amy Watts
- 1 Flinders University, Adelaide, Australia
| | - Gregory I Bain
- 1 Flinders University, Adelaide, Australia.,2 Department of Orthopaedic Surgery and Trauma, Flinders Medical Centre, Adelaide, Australia
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Mahjoub S, Dunet B, Thoreux P, Masquelet AC. Transverse translunate fracture-dislocation: A rare injury. HAND SURGERY & REHABILITATION 2016; 35:220-224. [PMID: 27740466 DOI: 10.1016/j.hansur.2016.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/13/2016] [Accepted: 02/29/2016] [Indexed: 11/18/2022]
Abstract
Perilunate fracture-dislocation is rare. We report the case of a 24-year-old male who fell from his motorcycle and presented with a transverse lunate fracture with perilunate ligament damage. The initial diagnosis based on X-rays was confirmed by CT scan. A dorsal approach was used to obtain good reduction, double screw fixation and ligament reinsertion protected by temporary K-wires. To the best of our knowledge, this is the first case of transverse lunate fracture within perilunate fracture-dislocation. The patient returned to normal activities after 6 months.
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Affiliation(s)
- S Mahjoub
- Service de chirurgie orthopédique et traumatologique, hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France; Service de chirurgie orthopédique et traumatologique, hôpital de Libourne, 112, rue de la Marne, 33505 Libourne, France
| | - B Dunet
- Unité membre supérieur, service de chirurgie orthopédique et traumatologique, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; Service de chirurgie orthopédique et traumatologique, hôpital de Libourne, 112, rue de la Marne, 33505 Libourne, France.
| | - P Thoreux
- Service de chirurgie orthopédique et traumatologique, hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France
| | - A C Masquelet
- Service de chirurgie orthopédique et traumatologique, hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France
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A rare coronal fracture of the medial carpal column: Case report. ACTA ACUST UNITED AC 2015; 34:94-7. [PMID: 25748586 DOI: 10.1016/j.main.2015.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 01/13/2015] [Accepted: 01/13/2015] [Indexed: 11/22/2022]
Abstract
Carpal coronal fractures are rare. We report the case of a 15 year-old male who fell from a balcony and suffered a displaced coronal fracture of the capitate, hamate and triquetrum. The diagnosis, which was initially made based on the X-rays, was confirmed by CT scan. Open reduction and internal fixation using Herbert screws was performed. To the best of our knowledge, this is the first published case of a coronal fracture of these three bones. The patient returned to normal activities after six months.
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Shin DH, Shin AY. Volarly displaced transscaphoid, translunate, transtriquetrum fracture of the carpus: case report. J Hand Surg Am 2014; 39:1507-11. [PMID: 24785696 DOI: 10.1016/j.jhsa.2014.02.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 02/20/2014] [Accepted: 02/22/2014] [Indexed: 02/02/2023]
Abstract
A 16-year-old girl sustained a transscaphoid, translunate, transtriquetrum volarly displaced fracture due to shear stress in the coronal plane. Treatment involved open reduction and internal fixation of the fractures followed by immobilization. At 15 months' follow-up, grip strength and motion were diminished compared with the uninjured wrist. Radiographs demonstrated fully healed fractures with narrowing of the cartilage space between the capitate and the lunate.
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Affiliation(s)
- David H Shin
- Orthopedic Department, Mayo Clinic, Rochester, MN
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Abstract
Purpose To review a series of translunate perilunate dislocations to analyze the, mechanism of injury, diagnosis, management, and outcome. Methods A literature review and a survey of the International Wrist Investigators Workshop were performed to locate cases. Results Translunate perilunate injuries are rare. There is a spectrum of severity. The mechanism of injury is usually high-energy, and multiple fractures are the norm. High-energy mechanism, perilunate dislocation, comminuted lunate fracture and delayed presentation greater than 7 days are associated with a higher likelihood of a salvage procedure being required. Discussion Translunate injuries are a complex variant of perilunate dislocations. Early diagnosis is critical in understanding the complexity of the injury. Lunate fixation should be performed prior to bony and ligamentous stabilization of the proximal row. In delayed or highly comminuted cases, salvage procedures are the preferred option. Including a translunate arc in addition to the greater and lesser carpal arc would lead to a more inclusive classification. Level of Evidence Level IV.
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Affiliation(s)
| | - Samuel Pallapati
- Paul Brand Centre of HLRS, Christian Medical Centre, Vellore, India
| | - Kevin Eng
- Department of Orthopaedic Surgery, Modbury Public Hospital, Adelaide, Australia
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Nondisplaced fractures of the proximal carpal row: case report. J Hand Surg Am 2011; 36:1310-2. [PMID: 21741779 DOI: 10.1016/j.jhsa.2011.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 05/23/2011] [Accepted: 05/25/2011] [Indexed: 02/02/2023]
Abstract
We present a 24-year-old woman who sustained isolated nondisplaced fractures of the proximal carpal row after a low-energy injury. The radiographic features are most consistent with the recently described translunate arc injury and appear to be a transitional injury between an inferior arc injury as well as the greater and lesser arc injuries. The injury was successfully treated with below-elbow thumb-spica cast immobilization for 10 weeks.
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Abstract
A patient reported that he sustained a minor fall on the outstretched hand in hyperextension, pronation, and in ulnar deviation. Initial radiographs suggested dorsal transscaphoid-transtriquetral perilunate dislocation. Traditionally, however, this injury is the result of a high-energy impact. A CT scan obtained after closed reduction of the dislocation revealed not only a fresh fracture of the triquetrum but also two corticalized fragments of the scaphoid. A former major fall on this hand and a normal scaphoid of the other hand made pseudarthrosis more likely than scaphoid bipartition. Arthrography revealed intact lunotriquetral and scapholunate ligaments, precluding the possibility of preexisting ligamentous instability. Pseudarthrosis of the scaphoid with a loss of scaphoid function as a mechanical tie-rod of the carpus is most likely responsible for this complex injury. This is the first clinical study that shows that single scaphoid discontinuity without preexisting ligamentous carpal instability may lead to complex perilunar dislocation in minor trauma.
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Affiliation(s)
- V Alt
- C.H.G. Sarrebourg, Service de chirurgie orthopédique, Sarrebourg, France.
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