| Perilunate fracture-dislocations of the wrist: comparison of temporary screw versus K-wire fixation. | |
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MedLine Citation:
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PMID: 17336837 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Temporary intercarpal screw fixation has been suggested as an alternative to temporary K-wire fixation in the treatment of perilunate wrist dislocations. We compared the 2 treatment methods in 2 retrospective cohorts with a null hypothesis that there would be no difference in final wrist motion. METHODS: Eighteen patients with surgically treated perilunate wrist dislocations (9 treated with intercarpal screws, 9 with intercarpal K-wires) were evaluated an average of 44 months after injury. The intercarpal screws were removed an average of 5 months and the K-wires an average of 3 months after the initial procedure. Complications included 3 pin track infections (1 with wrist sepsis), 2 scaphoid nonunions (screw fixation), and 2 patients with loss of reduction (K-wire fixation) treated with repeat surgery. RESULTS: Four patients (2 in each cohort) had wrist arthrodesis with poor results. Among the 14 remaining patients the final flexion arc was 97 degrees for patients treated with screw fixation compared with 73 degrees for patients treated with K-wires. The mean grip strength was 74% (screw fixation) and 67% (K-wire) that of the uninjured arm. According to the Mayo Modified Wrist Score, the functional result was excellent in 1 patient (screw), good in 2 patients (1 each group), fair in 6 patients (3 in each group), and poor in 9 patients (4 screws, 5 K-wire). Seven patients (2 screws, 5 K-wires) had grade 2 or 3 midcarpal arthritis according to the criteria of Knirk and Jupiter, but none had more than mild radiocarpal arthritis. CONCLUSIONS: The results of treatment with temporary screws are comparable to the results of treatment with temporary K-wires. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III. |
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Authors:
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J Sebastiaan Souer; Marijn Rutgers; Jonas Andermahr; Jesse B Jupiter; David Ring |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of hand surgery Volume: 32 ISSN: 0363-5023 ISO Abbreviation: J Hand Surg Am Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-05 Completed Date: 2007-04-17 Revised Date: 2009-06-08 |
Medline Journal Info:
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Nlm Unique ID: 7609631 Medline TA: J Hand Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 318-25 Citation Subset: IM |
Affiliation:
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Hand and Upper Extremity Service, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Bone Screws Bone Wires Dislocations / radiography, surgery* Female Fracture Fixation, Internal / methods* Fractures, Bone / radiography, surgery* Humans Ligaments, Articular / physiology* Lunate Bone / injuries*, radiography Male Middle Aged Wrist Injuries / radiography, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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