Complete palmer lunate enucleation---is proximal row carpectomy or wrist arthrodesis the only choice?
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Perilunate dislocations are rare injuries of the wrist and complete dislocation of the lunate is also rare. There is controversy in literature regarding the optimal management of such injuries. Complete lunate enucleation is associated with high rate of osteonecrosis of lunate thus wrist arthrodesis or proximal row carpectomy has been advocated as primary treatment for such injuries. We report a case of transradial styloid complete palmar lunate enucleation in a 25-year-old male patient who sustained injury to the left wrist due to fall on outstretched hand. Carpal row salvage surgery initially by closed reduction and wrist distractor application followed by open reduction and internal fixation with K-wires along with ligamentous repair resulted in restoration of normal wrist anatomy and good functional outcome. As many of these injuries are missed on initial presentation and outcome is poor for missed injuries, prompt diagnosis and early surgical management to restore vascularity of lunate is recommended. (+info)
Long-term results of silicone rubber implants for Kienbock's disease.
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Between 1971 and 1976 eight patients underwent excision of the carpal lunate for pain from Kienbock's disease. The bone was replaced by a silicone rubber implant. An average of 84 months had elapsed when they were reviewed in December 1980. All eight were very satisfied with their operations. Objectively, the clinical results were good, but radiographs showed the presence of degenerative change in the region of the wrist and alteration of the position of the prosthesis on ulnar deviation of the hand. No implant has had to be removed. (+info)
Perilunate fracture-dislocation: a continually missed injury.
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Five cases of perilunate fracture-dislocation are presented in which the radiological appearances were typical but the diagnoses were initially missed. A simple systematic method of x ray analysis is described. (+info)
Kienbock's disease in cerebral palsy.
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Five cases of Kienbock's disease occurring in a group of fifty-three adults with cerebral palsy are described. The increased incidence of the disease is attributed to the flexed posture habitual in the affected wrist and to an effect on the pattern of blood supply to the lunate. (+info)
Fracture-dislocation of the lunotriquetral coalition.
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Bony fusions involving the carpus have a much higher prevalence in blacks relative to whites. This article describes a case of lunotriquetral coalition fracture-dislocation in an African American. This lesion is best treated through open reduction and pin fixation. (+info)