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Background: The purpose of this study was to evaluate the treatment outcomes of perilunate dislocations (PLDs) and transscaphoid perilunate fracture dislocations (TSPLDs) treated with operative volar approach without ligament repair or reconstruction.
Methods: A total of seven patients (10 hands) were studied during 2017-2018. We fixed scaphoid fractures thorough a volar approach and 3 k-wires were inserted to stabilize the scaphoid to the adjacent bones. We evaluated patients' range of motion by VAS and grip strength, sensitivity assessment, and radiographs. Mayo and DASH scores were also recorded for wrist evaluation.
Results: All fractures united well. The mean Mayo wrist score was 81.5. Five patients scored good and excellent results (90-100). Excellent DASH scores (˂20) were observed in 4 patients and there was no poor DASH score (˃50).
Conclusion: Treatment of PLDs and TSPLDs with k-wire and screw fixation using a volar approach and without any ligament repair or reconstruction results in minimal manipulation and has favorable short-term outcomes.
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http://dx.doi.org/10.22038/abjs.2020.42341.2152 | DOI Listing |
Hand (N Y)
September 2025
Department of Hand and Orthopedic Surgery, Faculty of Medicine and Health, Örebro University, Sweden.
Background: In distal radius fracture (DRF) surgery with volar locking plates, the flexor carpi radialis approach is commonly used. However, the volar central approach (VCA), between the median nerve and the finger flexors, may improve visualization of the volar ulnar corner. A similar approach has been linked with a higher risk of iatrogenic median neuropathy.
View Article and Find Full Text PDFJ Hand Microsurg
November 2025
Hand Surgeon, Private Practice, C. de Serrano, 58, Salamanca, 28001, Madrid, Spain.
Scapholunate (SL) instability remains a challenging condition with significant possibility of implications for wrist function and long-term outcomes. This review explores the limitations and complications of current trans-osseous scapholunate ligament (SLL) reconstruction techniques, focusing on isometric reconstruction challenges and complications, for example osteonecrosis, tunnel fractures, graft failure, and iatrogenic extrinsic ligament injuries. Through biomechanical analysis and clinical case reviews, we demonstrate that the conventional three-ligament tenodesis (3LT) scaphoid tunnel has high risk of resulting in a non-isometric volar scapho-trapezial (vST) ligament reconstruction, potentially exacerbating carpal instability.
View Article and Find Full Text PDFPediatr Rep
August 2025
Hand Surgery, Desert Orthopaedic Center, Las Vegas, NV 89121, USA.
Finger injuries are common in pediatric patients and typically heal well with conservative management. However, rare fracture patterns involving significant displacement and physeal injury, such as the one described in this case, require specialized surgical intervention to ensure proper healing and prevent long-term complications. A 12-year-old left-hand-dominant female presented with pain, swelling, and deformity at the distal interphalangeal (DIP) joint following hyperextension of the left fifth digit.
View Article and Find Full Text PDFJBJS Essent Surg Tech
August 2025
Duke University Medical Center, Durham, North Carolina.
Background: Scaphoid fractures are a common, yet challenging, injury to treat. The mini-open dorsal approach to the scaphoid is a simple, yet effective, approach that allows for improved visualization and more accurate screw placement in the setting of scaphoid fracture fixation.
Description: An approximately 2-cm longitudinal incision is made centered over the dorsal radiocarpal joint, just ulnar to the Lister tubercle.
Indian J Orthop
August 2025
Hand to Shoulder Division, Department of Orthopaedics, Max Smart SuperSpeciality Hospital, Saket, New Delhi, India.
Background: Distal radius fractures (DRFs) are among the most frequent injuries in older adults, especially those with osteoporosis. In India, these fractures are becoming more common due to longer life spans, changing lifestyles, and increasing rates of undiagnosed osteoporosis.
Objective: To explore the growing burden of osteoporotic DRFs and evaluate current approaches to their management, focusing on both non-surgical and surgical strategies tailored for the aging population.