[Arthroscopic management of lesser arc perilunate injuries].

OBJECTIVE: To evaluate the outcomes of lesser arc perilunate injuries (Perilunate dislocations) treated with arthroscopically assisted mini-invasive reduction and fixation.

METHODS: Between 2012 and 2014, 5 patients who had a perilunate dislocation were treated with arthroscopically assisted reduction and percutaneous fixation. The mean follow-up was 17.8 months (range, 10 to 32 months). Clinical outcomes were evaluated on the basis of range of motion; grip strength; Mayo wrist score; Quick disabilities of the arm, shoulder and hand questionnaire; and patient-rated wrist evaluation score. Radiographic evaluations included carpal alignments and any development of arthritis.

RESULTS: The range of flexion-extension motion of injured wrist averaged 84% of the values for contralateral wrist. The grip strength of the injured wrist averaged 90% of the values for the contralateral wrists. The mean Quick Disabilities of the arm, shoulder and hand score was 1, and the mean Patient-Rated Wrist Evaluation score was 5. According to the Mayo wrist scores, the overall functional outcomes were rated as excellent in all the patients. Reduction obtained during the operation was maintained within normal ranges in all the patients. Arthritis had not developed in any patient at the end of the follow-up.

CONCLUSION: Arthroscopic mini-invasive reduction with percutaneous fixation is a reliable and favorable alternative in the treatment of perilunate dislocations according to our early results.