Revista de la Asociación Argentina de Ortopedia y Traumatología
On-line version ISSN 1852-7434
BAGLIARDELLI, Julio et al. Carpus fracture-dislocations: radiologic and functional outcomes after surgical treatment. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2012, vol.77, n.1, pp. 6-16. ISSN 1852-7434.
Background: Dislocations and fracture dislocations of the carpal bones are potencially devastating lesions and they are often misdiagnosed or diagnosed late. The purpose of this study is to evaluate radiological and functional outcome after their surgical treatment. Methods: Twenty-seven patients with different types of dislocations or fracture dislocations of the carpus were retrospectively evaluated between 2004 and 2010. Patients age averaged 28 years. Eleven were acute injuries, eleven subacute and five chronic injuries. The injury patterns were five perilunar dislocations, one mid carpal dislocation and twenty one perilunar fractures-dislocations. Results: Follow up averaged 14 months. Carpal angle averaged 130º, scapholunate angle averaged 46º, lunateos magnum angle averaged 23º, carpal hight averaged 1,56, Scapholunate interval averaged 1,5 mm. Functional outcomes averaged 60º for flexion, 43º for extension, 16º for ulnar deviation, 17º for radial deviation, 77º for pronation, 72º for supination. Strength tests averaged: dynamometer 27 kg, clamp key digitometer test 9 kg, tridigital clamp test 7 kg. DASH Score averaged 33 points. Analogical scale of pain averaged 6,5 points. Conclusion: Many aspects of this injury are yet to be studied or are still unknown. It is important to recognize and solve as quick as possible this kind of injuries by a surgical procedure that allows optimal bone reduction and ligament repair using a double surgical approach when needed.
Keywords : Fractures-dislocation; Carpal dislocation.