Evidence map›Paper›PMID 39751639›Full record

ArticleArchives of orthopaedic and trauma surgery2025

Do perilunate dislocations and fracture-dislocations result in different radiological outcomes following wrist alignment reconstruction? A single-center retrospective study including 51 patients with perilunate injuries.

Katarzyna Rachunek-Medved, Fabian Medved, Wojciech Besz, Claudius Illg, Henrik Lauer, Sabrina Krauß, Adrien Daigeler, Johannes Tobias Thiel

Abstract read
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Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Katarzyna Rachunek-MedvedDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany. katarzyna.rachunek91@gmail.com.
Fabian MedvedDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Wojciech BeszDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Claudius IllgDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Henrik LauerDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Sabrina KraußDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Adrien DaigelerDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.
Johannes Tobias ThielDepartment of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tübingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPerilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are high-energy wrist injuries often linked to significant post-traumatic osteoarthritis. This study aims to determine whether PLD and PLFD yield different radiological outcomes following surgical treatment while identifying prognostic factors for worse outcomes. MATERIALS AND

methodsWe retrospectively analyzed 51 patients treated for perilunate injuries between 2000 and 2022. Radiographic evaluation included postoperative carpal alignment, scapholunate distance, ulnar translocation, and postoperative arthrosis according to the Kellgren-Lawrence scale. Logistic regression models were used in the study. The analyzed explanatory variables included: type of injury (PLFD/PLD), Mayfield classification, capsulodesis, repair of intercarpal- and extrinsic ligaments, and number of wrist transfixations. The significance level was set at p ≤ 0.05. The calculations were performed with R (version 4.3.2).

resultsAmong 51 patients, the mean follow-up was 4.33 years (1-22.13), and the mean age was 37.76 years. PLFD accounted for 55% of cases. Patients in the PLD group were older at the time of injury (p = 0.0031) compared to PLFD. Older patients presented also with higher stages of perilunate instability (p = 0.0061). Midcarpal arthrosis was the most common site of wrist degeneration (58.8%). Ordinal logistic regression indicated that PLFD was associated with a lower risk of midcarpal arthrosis (OR = 0.293, p = 0.04), while a higher number of wrist transfixations increased the risk of advanced arthrosis (OR = 2.427, p = 0.02), The logistic regression model detected a positive effect of the number of wrist transfixations on lunate fovea arthrosis (p = 0.048). The number of wrist transfixations did not correlate with the number of fractures (p = 0.06), Mayfield classification (p = 0.16), or intraoperative reduction outcome (p = 0.6).

conclusionPLD and a greater number of wrist transfixations were associated with a higher risk of wrist arthrosis. Limiting wrist pinning to essential procedures may help prevent additional iatrogenic chondral lesions.

Indexed as

Fracture DislocationLunate BoneWrist InjuriesAdolescentAdultAgedFemaleHumansJoint DislocationsMaleMiddle AgedRadiographyRetrospective StudiesTreatment OutcomeWrist JointYoung AdultPerilunate dislocationsPerilunate fracture dislocationsPerilunate luxationWrist arthrosisWrist surgery

Identifiers

PMID39751639
PMCPMC11698771

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.