Zyluk Andrzej, Piotuch Bernard, Puchalski Piotr
Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.
Pol Orthop Traumatol. 2013 Jan 23;78:41-5.
Complex, perilunate fracture-dislocations of the wrist comprise severe and challenging injuries, characterised by a total loss of contact between the lunate bone and the head of the capitate as well as fracture of one, or more bones surrounding lunate bone. The principle of treatment of such injuries involves stable fixation of fractures, anatomical reduction of the displaced carpal bones with temporary arthrodesis wit K-wires to maintain their position. We present a patient who sustained a complex, perilunate fracture-dislocation of the wrist with fractures of the scaphoid, hamate and base of the IV metacarpal bone, as a result of a blast. Assessment at one year after the surgery showed satisfactory result: mean range of motion in the wrist was 50-60% of the healthy side, grip strength was 55%, DASH score of 36 and Mayo score of 65.
腕部复杂的月骨周围骨折脱位是严重且具有挑战性的损伤，其特征是月骨与头状骨头部完全失去接触，以及月骨周围一块或多块骨骼骨折。此类损伤的治疗原则包括骨折的稳定固定、用克氏针临时关节固定术对移位腕骨进行解剖复位以维持其位置。我们报告一名因爆炸导致腕部复杂的月骨周围骨折脱位并伴有舟骨、钩骨和第四掌骨基部骨折的患者。术后一年的评估显示结果令人满意：腕部平均活动范围为健侧的50 - 60%，握力为55%，DASH评分为36分，Mayo评分为65分。
