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Two stage procedure for neglected transscaphoid perilunate dislocation.

Lal H, Jangira V, Kakran R, Mittal D - Indian J Orthop (2012)

Bottom Line: In the first stage, bilateral uniplanar wrist distractor was applied with the aim of stretching soft tissue.In the next stage open reduction and internal fixation was done by a combined volar and dorsal approach augmented by pronator quadratus flap.At 3 years followup the patient was pain free and had a full range of supination pronation of the forearms and radial and ulnar deviation of wrist with 10° dorsiflexion deficit.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, Chandigarh, India.

ABSTRACT
We report a two-staged surgical procedure for neglected 3 month old volar transscaphoid, transcapitate perilunate fracture dislocation wrist in an 18 year old right handed male student. The lunate with proximal scaphoid and proximal capitate maintained its articulation with distal end radius while the rest of carpal bones had dislocated volarly. In the first stage, bilateral uniplanar wrist distractor was applied with the aim of stretching soft tissue. In the next stage open reduction and internal fixation was done by a combined volar and dorsal approach augmented by pronator quadratus flap. At 3 years followup the patient was pain free and had a full range of supination pronation of the forearms and radial and ulnar deviation of wrist with 10° dorsiflexion deficit.

No MeSH data available.


Related in: MedlinePlus

(a) Recent followup PA and lateral radiograph showing scapholunate angle of 40° and lunocapitate angle of 12° with no evidence of osteonecrosis of scaphoid/lunate and osteoarthritis. (b) Followup MRI scan of wrist T1and T2 images showing good alignment of carpal bones with no degenerative or avascular changes
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Figure 6: (a) Recent followup PA and lateral radiograph showing scapholunate angle of 40° and lunocapitate angle of 12° with no evidence of osteonecrosis of scaphoid/lunate and osteoarthritis. (b) Followup MRI scan of wrist T1and T2 images showing good alignment of carpal bones with no degenerative or avascular changes

Mentions: At the 3 year followup visit, the patient was pain free and had a full range of pronation with supination of the forearm and radial and ulnar deviation of the wrist. However, there was a 10° dorsiflexion deficit in the injured wrist [Figure 5]. MRI of the wrist revealed osseous union of the scaphoid and no evidence of radiocarpal or midcarpal arthritis. No osteonecrosis of the lunate or the proximal pole of the scaphoid was evident [Figure 6b]. His carpal indices were: Scapholunate angle 40°, lunocapitate angle 12°, and scapholunate distance 3 mm [Figure 6a].


Two stage procedure for neglected transscaphoid perilunate dislocation.

Lal H, Jangira V, Kakran R, Mittal D - Indian J Orthop (2012)

(a) Recent followup PA and lateral radiograph showing scapholunate angle of 40° and lunocapitate angle of 12° with no evidence of osteonecrosis of scaphoid/lunate and osteoarthritis. (b) Followup MRI scan of wrist T1and T2 images showing good alignment of carpal bones with no degenerative or avascular changes
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377149&req=5

Figure 6: (a) Recent followup PA and lateral radiograph showing scapholunate angle of 40° and lunocapitate angle of 12° with no evidence of osteonecrosis of scaphoid/lunate and osteoarthritis. (b) Followup MRI scan of wrist T1and T2 images showing good alignment of carpal bones with no degenerative or avascular changes
Mentions: At the 3 year followup visit, the patient was pain free and had a full range of pronation with supination of the forearm and radial and ulnar deviation of the wrist. However, there was a 10° dorsiflexion deficit in the injured wrist [Figure 5]. MRI of the wrist revealed osseous union of the scaphoid and no evidence of radiocarpal or midcarpal arthritis. No osteonecrosis of the lunate or the proximal pole of the scaphoid was evident [Figure 6b]. His carpal indices were: Scapholunate angle 40°, lunocapitate angle 12°, and scapholunate distance 3 mm [Figure 6a].

Bottom Line: In the first stage, bilateral uniplanar wrist distractor was applied with the aim of stretching soft tissue.In the next stage open reduction and internal fixation was done by a combined volar and dorsal approach augmented by pronator quadratus flap.At 3 years followup the patient was pain free and had a full range of supination pronation of the forearms and radial and ulnar deviation of wrist with 10° dorsiflexion deficit.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, Chandigarh, India.

ABSTRACT
We report a two-staged surgical procedure for neglected 3 month old volar transscaphoid, transcapitate perilunate fracture dislocation wrist in an 18 year old right handed male student. The lunate with proximal scaphoid and proximal capitate maintained its articulation with distal end radius while the rest of carpal bones had dislocated volarly. In the first stage, bilateral uniplanar wrist distractor was applied with the aim of stretching soft tissue. In the next stage open reduction and internal fixation was done by a combined volar and dorsal approach augmented by pronator quadratus flap. At 3 years followup the patient was pain free and had a full range of supination pronation of the forearms and radial and ulnar deviation of wrist with 10° dorsiflexion deficit.

No MeSH data available.


Related in: MedlinePlus