Arthroscopic reduction and percutaneous fixation of perilunate dislocations and XXXX .

@entity1 @entity625 @entity174
PURPOSE: The purpose of this study was to review clinical and radiographic outcomes of perilunate dislocations and @entity174 treated with arthroscopic reduction and percutaneous fixation. METHODS: Twenty @entity1 who had an acute dorsal perilunate dislocation or @entity174 were treated with an arthroscopic technique at a median interval of 3.9 days from the time of injury. They were retrospectively reviewed at a mean follow-up of 31.2 months (range, 18 to 61 months). Range of motion and grip strength were measured. Radiographic evaluations included time to scaphoid union, measurement of radiologic parameters, and any development of @entity625 . Functional outcomes were determined by the modified Mayo wrist score; Disabilities of the Arm, Shoulder and Hand questionnaire; and @entity1 -Rated Wrist Evaluation score. RESULTS: The flexion-extension motion arc and grip strength of the injured wrist averaged 79% and 78%, respectively, of the corresponding values for the contralateral wrists. The mean Disabilities of the Arm, Shoulder and Hand score was 18, and the mean @entity1 -Rated Wrist Evaluation score was 30. According to modified Mayo wrist scores, overall functional outcomes were rated as excellent in 3 @entity1 , good in 8, fair in 7, and poor in 2. Nonunion developed in 2 @entity1 with a trans-scaphoid perilunate injury; 1 of the 2 underwent scaphoid excision and midcarpal fusion. On the basis of radiographic parameters, reduction obtained during the operation was maintained within normal ranges in 15 @entity1 . @entity625 had not developed in any @entity1 by the last follow-up. CONCLUSIONS: This study suggests that arthroscopic reduction with percutaneous fixation is a reliable minimally invasive surgical method for acute perilunate injuries in that it provides proper restoration and stable fixation of carpal alignment and results in satisfactory functional and radiologic outcomes on a midterm basis. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
