[Review of 10 patients with pure perilunate carpal dislocation at a minimum of 18years follow-up].

IF 0.4 4区 医学 Q4 SURGERY Annales De Chirurgie Plastique Esthetique Pub Date : 2024-09-21 DOI:10.1016/j.anplas.2024.08.001
M Boukhaled, C Dumontier, L Cathala, A-P Uzel
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Abstract

Objective: To evaluate, in long-term, the functional abilities and the occurrence of osteoarthritis in patients treated for a posterior perilunate carpal dislocation without bone lesion associated.

Patients and method: This was a monocentric retrospective observational study on patients operated on at the University Hospital of Guadeloupe for a posterior perilunate dislocation without bone lesion associated with a minimum of 18years of follow-up. Ten patients were included with a mean follow-up of 22.8years. The evaluation criteria were clinical (PRWE, QuickDASH, pain, grip strength, wrist joint mobility, Watson and Reagan tests, Cooney functional score) and radiographic (Gilula curves, carpal height, carpal ulnar translation, scapholunate and radiolunar angles, scapholunate and triquetro-lunar interlines in statics and dynamics, Herzberg's classification of complications).

Results: The average Cooney score was 67.5/100. Mean PRWE and QuickDASH scores were 33.9 and 24.8 respectively. The mean flexion-extension arc on the injured side was 71.5° (66.7% compared to the healthy side). Mean grip strength was 27kg (72.8% compared to the healthy side). The prevalence of osteoarthritis was 60%, with three A types, two A1 types, one B type and four B1 types according to Herzberg.

Conclusion: The factors influencing the long-term prognosis are the initial displacement of the lunate, the quality of the reduction and the presence of chronic carpal instability, particularly scapholunate. The high prevalence of osteoarthritis in our series (60%) is apparently not correlated with the functional capacities of patients over the long term.

Level of evidence: 4:

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[对 10 名纯腕关节周围脱位患者进行至少 18 年的随访]。
目的长期评估无骨关节病变的腕关节后脱位患者的功能能力和骨关节炎的发生情况:这是一项单中心回顾性观察研究,研究对象是瓜德罗普大学医院因腕关节后周脱位而接受手术治疗的患者,随访时间至少18年。研究共纳入了 10 名患者,平均随访时间为 22.8 年。评估标准包括临床(PRWE、QuickDASH、疼痛、握力、腕关节活动度、Watson和Reagan测试、库尼功能评分)和影像学(Gilula曲线、腕骨高度、腕骨尺侧平移、肩胛骨与桡骨的夹角、肩胛骨与三叉月椎间线的静态和动态、赫茨伯格并发症分类):平均库尼评分为 67.5/100。PRWE 和 QuickDASH 平均得分分别为 33.9 分和 24.8 分。受伤一侧的平均屈伸弧度为 71.5°(与健康一侧相比为 66.7%)。平均握力为27公斤(与健侧相比为72.8%)。骨关节炎的发病率为60%,根据赫茨伯格标准,有3个A型、2个A1型、1个B型和4个B1型:影响长期预后的因素包括月骨的初始移位、截骨的质量以及是否存在慢性腕关节不稳定,尤其是肩胛骨不稳定。在我们的系列研究中,骨关节炎的高发病率(60%)显然与患者的长期功能能力无关:4:
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来源期刊
CiteScore
1.00
自引率
0.00%
发文量
86
审稿时长
44 days
期刊介绍: Qu''elle soit réparatrice après un traumatisme, pratiquée à la suite d''une malformation ou motivée par la gêne psychologique dans la vie du patient, la chirurgie plastique et esthétique touche toutes les parties du corps humain et concerne une large communauté de chirurgiens spécialisés. Organe de la Société française de chirurgie plastique reconstructrice et esthétique, la revue publie 6 fois par an des éditoriaux, des mémoires originaux, des notes techniques, des faits cliniques, des actualités chirurgicales, des revues générales, des notes brèves, des lettres à la rédaction. Sont également présentés des analyses d''articles et d''ouvrages, des comptes rendus de colloques, des informations professionnelles et un agenda des manifestations de la spécialité.
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