Abstract | OBJECTIVES: This study aims to evaluate the clinical and radiological outcomes of diamond-shaped Kirschner (K)-wire fixation for the treatment of acute perilunate dislocation ( PLD) or trans-scaphoid perilunate fracture dislocation (PLFD). PATIENTS AND METHODS: We performed a retrospective review of 18 patients (18 wrists; 17 males, 1 female; mean age 31.5±2.6 years; range, 18 to 47 years) treated for PLD/PLFD using a dorsal approach with the diamond-shaped K-wire fixation between November 2001 and September 2017. The mean follow-up of cohort was 27 (range, 13 to 74) months. Using a dorsal approach, open ligament repair and bone fixations were performed. Perilunate dislocation was reduced and the carpal bones and midcarpal joint were held in anatomical position using four K-wires transfixing the scapholunate (SL), lunotriquetral, scaphocapitate, and triquetrohamate joints in such a shape that each bone received two K-wires. RESULTS: The mean range of motion and grip strength measured using a Jamar® dynamometer of the injured wrist compared to the uninjured extremity were 84.3% and 78.8%, respectively. The mean Mayo wrist score was 78.3 (range, 70 to 90). The mean Visual Analog Scale score was 1.2 (range, 0 to 4). The average SL gap at the final follow-up evaluation was 1.62 (range, 1 to 2.3) mm. The mean SL and capitolunate angles were 49.3° (range, 40 to 75°) and 4.2° (range, 2 to 12°), respectively. CONCLUSION: Because every bone is fixed with two K-wires using this configuration, a closed ring is created; hence no motion is possible between the scaphoid, capitate, hamate, triquetrum, lunate and the midcarpal joint. We believe that diamond-shaped fixation may provide reliable fixation and satisfactory clinical outcomes in patients with PLD and PLFD.
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Authors | Tuna Özyürekoğlu, Mehmet Ali Acar |
Journal | Joint diseases and related surgery
(Jt Dis Relat Surg)
Vol. 32
Issue 1
Pg. 42-50
( 2021)
ISSN: 2687-4792 [Electronic] Turkey |
PMID | 33463417
(Publication Type: Journal Article)
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Topics |
- Adult
- Bone Wires
- Female
- Fracture Dislocation
(diagnostic imaging, surgery)
- Fracture Fixation, Internal
(adverse effects, instrumentation, methods)
- Fractures, Bone
(diagnostic imaging, surgery)
- Humans
- Joint Dislocations
(diagnostic imaging, surgery)
- Lunate Bone
(injuries, surgery)
- Male
- Outcome and Process Assessment, Health Care
- Radiography
(methods)
- Retrospective Studies
- Scaphoid Bone
(injuries, surgery)
- Wrist Injuries
(diagnostic imaging, surgery)
- Wrist Joint
(surgery)
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