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Comparative Outcome Analysis of Arthroscopic-Assisted Versus Open Reduction and Fixation of Trans-scaphoid Perilunate Fracture Dislocations

Authors
 Won-Taek Oh  ;  Yun-Rak Choi  ;  Ho-Jung Kang  ;  Il-Hyun Koh  ;  Kyung-Han Lim 
Citation
 ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, Vol.33(1) : 92-100, 2017 
Journal Title
 ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 
ISSN
 0749-8063 
Issue Date
2017
MeSH
Adult ; Arthroscopy ; Female ; Fracture Dislocation/diagnostic imaging ; Fracture Dislocation/surgery* ; Humans ; Lunate Bone/injuries* ; Lunate Bone/surgery ; Male ; Open Fracture Reduction ; Radiography ; Range of Motion, Articular ; Retrospective Studies ; Scaphoid Bone/injuries* ; Scaphoid Bone/surgery ; Treatment Outcome ; Young Adult
Abstract
PURPOSE: To compare union rates and clinical and radiological outcomes of arthroscopic-assisted reduction and fixation with those of open reduction and fixation in patients with trans-scaphoid perilunate fracture dislocations. METHODS: This retrospective study included consecutive patients with trans-scaphoid PLFDs who underwent arthroscopic-assisted reduction and fixation (group A) or open reduction and fixation (group O), and who were followed up for a minimum of 2 years between May 2005 and March 2013. We excluded initially missed patients. Each different surgeon who was on call had performed each experienced operation. These clinical outcomes were assessed: range of motion, grip strength, Mayo wrist score, and Disabilities of Arm, Shoulder, and Hand (DASH) score. For radiologic outcomes, the scapholunate angle, radiolunate angle, and lunotriquetral distance were measured. RESULTS: The total number of included patient was 20 (11 in group A and 9 in group O). Scaphoid union occurred in all patients except 1 individual (11 of 11 in group A, and 8 of 9 in group O). At the last follow-up, the mean flexion-extension arc was significantly greater in group A (125.0°) than in group O (105.6°) (P = .028). The mean grip strength was 81.1% that of the contralateral side in group A and 80.9% in group O (P = .594). The mean Mayo wrist score was 85.5 in group A and 79.4 in group O (P = .026), and the mean DASH score was 10.6 in group A and 20.8 in group O (P = .001); however, only the DASH score showed a minimum clinically important difference. The mean scapholunate angle, radiolunate angle, and lunotriquetral distance were similar between the 2 groups: 47.2°, 1.7°, and 2.0 mm in group A and 48.8°, 5.6°, and 2.1 mm in group O, respectively. CONCLUSIONS: Although both arthroscopic and open techniques achieved stability of the injured wrists in patients with trans-scaphoid PLFDs, it is shown that the arthroscopic-assisted technique showed a clinically meaningful better DASH score and greater flexion-extension arc with other parameters being similar.
Full Text
http://www.sciencedirect.com/science/article/pii/S0749806316305217
DOI
10.1016/j.arthro.2016.07.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Ho Jung(강호정) ORCID logo https://orcid.org/0000-0003-0273-1264
Koh, Il Hyun(고일현) ORCID logo https://orcid.org/0000-0001-9823-8516
Oh, Won Taek(오원택) ORCID logo https://orcid.org/0000-0003-1815-0851
Lim, Kyung Han(임경한) ORCID logo https://orcid.org/0000-0003-1535-3258
Choi, Yun Rak(최윤락)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154138
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