Open perilunate injury with lunate revascularization after complete ligamentous avulsion.
Publication/Presentation Date
5-12-2014
Abstract
Perilunate dislocations are a devastating injury to the carpus that carry a guarded long-term prognosis. Mayfield type 4 perilunate dislocations are rare, high-energy injuries that carry a risk for avascular necrosis (AVN) of the lunate. When AVN ensues and the carpus collapses, primary treatment with a proximal row carpectomy or arthrodesis has been advocated. This case reports a successful clinical result and revascularization of an extruded lunate with open reduction and internal fixation. This type 4, Gustilo grade 1 open perilunate dislocation exhibited complete avulsion of all lunate ligamentous attachments. Management included open reduction and internal fixation as well as carpal tunnel release through a combined dorsal and volar approach. Despite concerns for lunate AVN due to complete disruption of lunate vascularity, a 10-month postoperative clinical and radiographic examination demonstrated no pain with activities of daily living as well as a revascularized lunate.
Volume
2014
Issue
5
ISSN
2042-8812
Published In/Presented At
Arango, D., Tiedeken, N. C., Ayzenberg, M., & Raphael, J. (2014). Open perilunate injury with lunate revascularization after complete ligamentous avulsion. Journal of surgical case reports, 2014(5), rju041. https://doi.org/10.1093/jscr/rju041
Disciplines
Medicine and Health Sciences
PubMedID
24876511
Department(s)
Department of Surgery
Document Type
Article