PERILUNAR DISLOCATIONS OF THE CARPUS - RESULTS OF SURGICAL-TREATMENT

Between 1980 and 1990, 60 patients presenting with 62 peri-lunar dislo cations of the carpus have been surgically treated. One case was a sub luxation of the scaphoid and 61 were posterior perilunar dislocations, among them were 32 grade I, 23 grade II, 4 grade III, 2 unknown grade according to the Witvoet and Allieu scale. In 36 cases the scaphoid w as fractured in 5 were associated a fracture of the scaphoid and a sca pho-lunar dislocation. 48 cases have been reviewed after a 31 month fo llow-up average. The result was satisfactory in 83 per cent of these c ases, unsatisfactory results being observed in cases of delayed surger y or uncomplete reduction. In 36 cases a dynamic radiological examinat ion was available after a 36 month follow-up average. 27 wrists were s table, 9 were not (7 D.I.S.I., 2 V.I.S.I.) 8 of these were related to unsatisfactory reductions. Diagnosis was delayed in 10 cases which end ed with less satisfactory results. The authors think that conservative treatment is not adequate, they propose different surgical procedures according to the possible association of a fracture of the scaphoid.