This study addressed the following null hypotheses: 1) There are no demographic differences between patients with perilunate dislocation (
PLD) or
fracture-dislocation (PLFD); 2) There are no factors associated with the development of median nerve symptoms in the setting of a
PLD or PLFD; and 3) There are no factors associated with carpal tunnel release. Using a retrospective search of a prospective
trauma database, we identified all patients who had sustained a radiologically confirmed
PLD or PLFD over
a 10-year period at two trauma centers. From the medical records we identified median nerve symptoms and carpal tunnel release in addition to demographic and injury characteristics. Among the 71 patients treated for
PLD or PLFD, acute
median neuropathy was diagnosed in 33 patients (47 %). The only significant difference between
PLD and PLFD was a younger age with PLFD. No demographic or injury factors were associated with symptoms of
median neuropathy. Carpal tunnel release surgery during the initial operative management was related to the presence of median nerve symptoms and the trauma center. We report a high incidence of acute
median neuropathy accompanying perilunate
injuries. As there are no demographic or injury factors associated with symptoms of
median neuropathy; all patients with
PLD/PLFD merit equally high vigilance for acute
median neuropathy.
LEVEL OF EVIDENCE: Level III, prognostic study.