Lunate and perilunate dislocation.

BACKGROUND: Perilunate dislocation is an uncommon injury of the wrist due to hyperextension. The factors affecting its prognosis are still controversial. The aim of the present study was to review its fracture types, associated injuries, timing of surgery, different fixation methods and prognostic factors.
METHODS: Fourteen patients with perilunate dislocation or fracture dislocation were treated by open reduction and internal fixation, and were followed for at least 12 months. A functional scoring system and X-ray findings were used for follow-up evaluation.
RESULTS: Two patients had excellent results, six patients had good results, and four had fair results. Only two patients had poor results. Treatment delayed over one month, transscaphoid perilunar fracture dislocation, or fixation of the transscaphoid fracture with Kirschner wire was associated with poorer results.
CONCLUSIONS: Early diagnosis of perilunate dislocation, prompt open reduction and rigid fixation for fracture combined with ligament repair can give more promising results.