On-line version ISSN 2309-8309
SA orthop. j. vol.7 n.3 Pretoria Jul./Sep. 2008
GB FirthI; A AdenII
IMBBCh, Orthopaedic Registrar
IIFCS(Orth)SA, Senior Consultant Department of Orthopaedic Surgery, Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa
AIM: To determine the outcome of patients with isolated lunate and perilunate dislocations treated with a combined approach and anchor repair of the dorsal scapholunate interosseous ligament.
METHODS: A combined volar and dorsal approach with anchor repair of the dorsal scapholunate interosseous ligament was used to treat six patients with isolated lunate or perilunate dislocations. Patients were assessed using the Disabilities of the Arm, Shoulder and Hand Score (DASH) and Mayo Wrist Score; and radiolog- ically using the scapholunate angle, radiolunate angle and the scapholunate gap at final follow-up.
RESULTS: The mean time to surgery was 13.5 days. The mean time to final follow-up was 28.5 months. At final follow-up, the mean Mayo wrist score was 78.3. The mean DASH score was 13.7. The mean range of motion was 51° extension, 58° flexion, 11° radial deviation, 24° ulna deviation, 75° pronation and 78° supination. The mean grip strength was 31.9 kg which represented 73.9% of the contralateral grip strength. The mean scapholunate angle was 48°, the mean radiolunate angle was 9° and the mean scapholunate gap was 2 mm.
CONCLUSIONS: Vigilance with early diagnosis and appropriate treatment using this surgical technique results in good functional and radiological results for ligamentous lunate dislocations.
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Dr GB Firth
Department of Orthopaedics, Faculty of Health Sciences
University of the Witwatersrand, 2193 Parktown
Tel: (011) 717-2538; Fax: (011) 447-6148
This article was submitted to an ethical committee for approval. The content of this article is the sole work of the authors.
No benefits of any form have been derived from any commercial party related directly or indirectly to the subject of this article.