Perilunate dislocations of the carpus. A long-term review.

The long-term results of 19 perilunate dislocations of the carpus (including 9 transscapho-perilunate dislocations) were: good, 7 cases; fair, 8; poor, 4. The 9 transscapho-perilunate dislocations gave worse results than simple dislocations, with pseudarthrosis in 5 cases. Arthrosis was found in more than half the cases, more frequently in transscapho-perilunate dislocations and in cases associated with a fracture of the radial styloid. Radiographic signs of instability were observed in 8 wrists. The unstable wrists had a high incidence of arthrosis and showed decidedly worse clinical results compared to stable wrists (good, 1; fair, 4; poor, 3, as compared to good, 6 and fair 4). In all the unstable wrists we therefore believe that the results may be improved if the radiographic signs of instability are specifically looked for immediately after reduction so that abnormal anatomical relationships in the carpus can be corrected early.