Kozin S H
Department of Orthopaedic Surgery, Temple University School of Medicine, Philadelphia, PA 19140, USA.
J Am Acad Orthop Surg. 1998 Mar-Apr;6(2):114-20. doi: 10.5435/00124635-199803000-00006.
Perilunate injuries are severe disruptions of the carpus, which present a formidable challenge to the treating physician. Accurate recognition of the pattern of injury is not always straightforward. The injury can propagate through ligaments and/or bone, creating multiple variations of a basic injury pattern. Posteroanterior and lateral radiographs will depict a perilunate injury, but additional views may be necessary to appreciate subtle carpal fractures. Once the diagnosis has been established, early intervention is necessary for optimal results. An initial closed reduction with sedation and traction is performed to restore overall carpal alignment. However, subsequent closed or open reduction is necessary to restore anatomic alignment of all injured structures. The outcome of perilunate injuries correlates with the adequacy of reduction. Complications such as chondrolysis, carpal instability, and traumatic arthritis can occur despite satisfactory treatment.
月骨周围损伤是腕关节的严重脱位，给治疗医生带来了巨大挑战。准确识别损伤模式并非总是易事。损伤可通过韧带和/或骨骼蔓延，产生基本损伤模式的多种变体。正位和侧位X线片可显示月骨周围损伤，但可能需要额外的视图来发现细微的腕骨骨折。一旦确诊，为获得最佳效果，早期干预是必要的。首先进行镇静和牵引下的闭合复位，以恢复腕关节的整体对线。然而，随后需要进行闭合或切开复位，以恢复所有受损结构的解剖对线。月骨周围损伤的预后与复位的充分程度相关。尽管治疗满意，仍可能发生诸如软骨溶解、腕关节不稳定和创伤性关节炎等并发症。
