Short-Term Results of Combined Open Reduction and Internal Fixation in the Treatment of Trans-Scaphoid Perilunate Fracture-Dislocation

Abstract

Aim:This study aimed to evaluate the short-term clinical and radiographic results of combined open reduction and internal fixation in the treatment of trans-scaphoid perilunate fracture-dislocation (TSPLFD).Materials and Methods:Data of eight patients diagnosed with TSPLFD who underwent combined open reduction and internal fixation and followed for a minimum of 8 months were retrospectively analyzed. All patients underwent surgical treatment with an Acutrak® screw, ligament repair using suture anchors, and Kirschner wire. The functional outcomes were evaluated using the modified Mayo Wrist Scores and total active range of motion scale. Radiographic outcomes were assessed based on standard X-ray images of the wrist.Results:Of the patients, seven were male and one was female, and the median age was 32 years (range: 20-44). The median follow-up duration was 12 months (range: 8-16). According to the TAROM scores, the outcomes were excellent and good in one and seven patients, respectively. The median Mayo Wrist Scores were 84 (range: 80-95). Good radiographic results were achieved in all patients. No surgery-related complications such as infection, loss of reduction, and Sudeck’s atrophy were observed.Conclusion:Although TSPLFD is a rare condition, early diagnosis and surgical treatment yield favorable functional and radiographic results. However, post-traumatic arthritis and functional dissatisfaction may occur in the long term.

Keywords

• trans-scaphoid perilunate fracture-dislocation
• dorsal approach
• acutrak screw
• suture anchor
• kirschner wire