Journal List > J Korean Soc Surg Hand > v.19(4) > 1106472

Kim, Hyun, Shin, Park, Han, and Hong: Treatment of Anchor Suture with Kirschner Wires Fixation for Chronic Perilunate Dislocation

Abstract

Chronic lunate dislocations are very rare injuries comprising of less than 10% of all wrist injuries. Volar lunate dislocations account for less than 3% of perilunate dislocations. We present a case of a missed volar lunate dislocation for 6months after initial injury. He fell down and had hyperextension injury during his sports activity. When the patient visit in our hospital, neurologic symptom was developed in distribution of median nerve. Tingling sensation and radiation symptom was found in affected hand. A plain radiograph revealed a volar lunate dislocation. Nerve conduction studies confirmed compression of the median nerve at the wrist, carpal tunnel level. Operation was performed with open reduction of lunate, fixation with K-wires and anchor suture. The outcome was excellent in relieving pain, function, range of motion, grip strength. There was improvement in Mayo wrist score and disabilities of the arm, shoulder and hand score. So we report a patient and a operation technique which can be considered in similar cases.

REFERENCES

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Fig. 1.
(A) Anteroposterior view. (B) Lateral radiographs of the wrist before reduction and fixation. (C) Scapholunate angle (S-L), 13.6°.
jkssh-19-200f1.tif
Fig. 2.
(A) Magnetic resonance image sagittal view before operation (T2). (B) T1 enhance. (C) Coronal view before operation (T2). (D) T1 enhance.
jkssh-19-200f2.tif
Fig. 3.
Intraoperative finding. (A) Pre-reduction. (B) Post-reduction. (C) Intraoperative X-ray finding with anchor suture and K-wire fixation.
jkssh-19-200f3.tif
Fig. 4.
Schematic image of location for anchor suture.
jkssh-19-200f4.tif
Fig. 5.
(A) Anteroposterior view. (B) Lateral radiographs of the wrist following open reduction and fixation. (C) Scapholunate angle: 50.2°.
jkssh-19-200f5.tif
Fig. 6.
(A) Anteroposterior view. (B) Lateral radiographs of the wrist following 12 months after surgery. (C) Scapholunate angle: 51.4°.
jkssh-19-200f6.tif
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