Quintero Jorge I, Van Royen Kjell, Bouri Fadi, Muneer Mohammed, Tien Huey
Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY, USA.
SAGE Open Med Case Rep. 2021 Jul 12;9:2050313X211032398. doi: 10.1177/2050313X211032398. eCollection 2021.
This is a 39-year-old male, fell from a bike, left wrist with trans-styloid perilunate fracture dislocation that underwent open reduction internal fixation, 20 months after surgery the patient developed avascular necrosis of the lunate, final wrist fusion was performed secondary to the arthritic changes on the wrist. Anatomic dissection was performed and vascularity of the lunate was identified, its origin is from the volar palmar arch, when dislocated palmarly and more than 90 degrees the vessel is still intact. More than 512 patients with perilunate dislocation and perilunate fracture dislocation are included we identified in the literature transient avascular necrosis of the lunate in nine and seventeen of pure avascular necrosis of the lunate. Concluding that avascular necrosis of the lunate after perilunate dislocation or perilunate fracture dislocation is an infrequent finding especially when the volar ligaments are intact.
这是一名39岁男性，从自行车上摔落，导致左腕经茎突月骨周围骨折脱位，接受了切开复位内固定术。术后20个月，患者出现月骨缺血性坏死，最终因腕关节的关节炎改变而进行了腕关节融合术。进行了解剖并确定了月骨的血管供应，其起源于掌侧掌弓，当向掌侧脱位超过90度时，血管仍然完整。我们在文献中发现，超过512例月骨周围脱位和月骨周围骨折脱位患者中，有9例出现月骨短暂性缺血性坏死，17例出现月骨单纯缺血性坏死。结论是，月骨周围脱位或月骨周围骨折脱位后发生月骨缺血性坏死是一种罕见的情况，尤其是在掌侧韧带完整时。
