A Comparison of Outcomes in Acute Perilunate Injuries: Systematic Review and Meta-Analysis of Treatment Approaches.

IF 1.8 Q2 ORTHOPEDICS

HAND Pub Date : 2025-07-01 Epub Date: 2024-02-28 DOI:10.1177/15589447241231291

Matthew V Abola, Brett A Gerber, Madeline C Rocks, Jeffrey S Chen, Jacques H Hacquebord, Ali Azad

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引用次数: 0

Abstract

Background: Perilunate dislocations (PLD) and fracture-dislocations (PLFD) comprise a spectrum of high-energy wrist injuries. The purpose of this review was to review operative strategies for perilunate injuries based on approach and compare outcomes.

Methods: A systematic review of literature on PLD and fracture-dislocations was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed and EMBASE databases were queried for literature. Inclusion criteria included English studies reporting clinical or functional outcomes of acute PLD and PLFD.

Results: Twenty-nine full-text articles (604 PLD and PLFD injuries) were included. The most common method of PLD and PLFD fixation is through an open approach with combined volar and dorsal exposure. There were no differences between approaches with regard to total arc range of motion, grip strength, Mayo Wrist Score, or mean scapholunate angle. Similarly, there was no difference between approaches and postoperative radiographic arthritis or complications. Most patients were able to return to their prior level of function and work. The incidence of postoperative complications ranged from 0% to 22.5%.

Conclusion: Current evidence shows no difference in postoperative total wrist arc range of motion, grip strength (as compared to contralateral), or Mayo Wrist Score with regard to surgical approach. The most common method of PLD and PLFD fixation in the literature is through an open approach with combined volar and dorsal exposure. There is a large difference in reported rates of radiographic arthritis, although this finding does not appear to correlate with postoperative pain or disability.

Level of evidence: I, Systematic Review.

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急性肛周损伤的疗效比较：治疗方法的系统回顾和元分析。

背景：腕关节周围脱位（PLD）和骨折脱位（PLFD）是一种高能量腕关节损伤。本综述的目的是根据手术方法对腕关节周围损伤的手术策略进行综述，并对结果进行比较：方法：根据《系统综述和荟萃分析首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses，PRISMA）对有关PLD和骨折脱位的文献进行了系统综述。检索了 PubMed 和 EMBASE 数据库中的文献。纳入标准包括报告急性PLD和PLFD临床或功能结果的英文研究：结果：共纳入 29 篇全文文章（604 例 PLD 和 PLFD 损伤）。最常见的PLD和PLFD固定方法是采用开放式方法，同时进行足背和足侧暴露。不同方法在总弧度活动范围、握力、梅奥腕关节评分或平均肩胛角方面没有差异。同样，不同方法在术后放射性关节炎或并发症方面也没有差异。大多数患者都能恢复到以前的功能和工作水平。术后并发症的发生率从0%到22.5%不等：目前的证据显示，手术方法不同，术后腕关节总弧度活动范围、握力（与对侧相比）或梅奥腕关节评分没有差异。文献中最常见的PLD和PLFD固定方法是采用开放式方法，同时暴露腕关节的外侧和背侧。据报道，放射性关节炎的发生率存在很大差异，但这一发现似乎与术后疼痛或残疾无关：证据级别：I，系统综述。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.