Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA.
J Am Acad Orthop Surg. 2011 Sep;19(9):554-62. doi: 10.5435/00124635-201109000-00006.
Perilunate dislocations and perilunate fracture-dislocations usually result from high-energy traumatic injuries to the wrist and are associated with a characteristic spectrum of bony and ligamentous damage. Radiographic evaluation of the wrist reveals loss of normal radiocarpal and intercarpal colinearity and bony insult, which may be overlooked at the initial presentation. Prompt recognition is important to optimize outcomes. Closed reduction is performed acutely, followed by open reduction and ligamentous and bony repair with internal fixation. Complications include posttraumatic arthrosis, median nerve dysfunction, complex regional pain syndrome, tendon problems, and carpal instability. Despite appropriate treatment, loss of wrist motion and grip strength, as well as persistent pain, is common. Medium- and long-term studies demonstrate radiographic evidence of midcarpal and radiocarpal arthrosis, although this does not correlate with functional outcomes.
舟月骨脱位和舟月骨骨折脱位通常是由高能创伤性腕部损伤引起的，与特征性的骨和韧带损伤谱相关。腕关节的放射学评估显示正常的桡腕和腕骨对线丧失和骨损伤，这可能在初次就诊时被忽视。及时识别非常重要，可以优化治疗效果。急性闭合复位，然后进行切开复位，以及韧带和骨修复，内固定。并发症包括创伤后关节炎、正中神经功能障碍、复杂性区域疼痛综合征、肌腱问题和腕不稳定。尽管进行了适当的治疗，但是腕关节运动和握力丧失以及持续性疼痛仍然很常见。中、长期研究显示存在腕中关节和腕骨关节炎的放射学证据，尽管这与功能结果无关。
