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Outcomes after perilunate dislocation/fracture dislucation

(2016) Niezen, C.K.

Introduction: Perilunate dislocation (PLD) and perilunate fracture dislocation (PLFD)
comprise 7% of all carpal injuries and are typically seen in high energetic traumas or falls
from heights. Immediate surgical treatment is necessary to ensure the likelihood of a positive
outcome. Even then a prevalence of posttraumatic arthritis (PA) up to 56% has been reported.
PA can influence the patients’ hand performance in a negative manner. However, a good
functional outcome is also seen in mild PA on radiographic imaging. Due to a wide variety of
outcomes in literature, it is necessary to determine baseline doctor reported outcome measures
(DROMs) and patient reported outcome measures (PROMs) of patients with PLD/PLFD. This
in order to determine the need for rehabilitation, and to further objectify outcome in
comparison to a healthy person.
Objective: Comparing DROMs and PROMs of PLD/PLFD patients with control patients.
Material & Methods: Eleven patients were included. DROMs (range of motion and grip
strength) were measured using Biometrics LTD hardware and E-Link® software. PROMs
were objectified using 5 validated questionnaires: VAS, PRWE, DASH, SF36, MHQ.
Results: A significantly lower active range of motion flexion/extension (aROMF/E) and
active range of motion ulnar/radial deviation (aROMU/R) was found in the PLD/PLFD group
(P<0.001). The PLD/PLFD patient had more pain and daily or general functioning were poor
(P<0.001). Although PLD/PLFD patients scored significantly lower on satisfaction
(P<0.001), no difference was found regarding work (P=0.281).
Conclusion: PLD/PLFD in literature are known as debilitating injuries. This research shows
that this injury causes decreased mobility and pain, causing the PLD/PLFD patient to be less
satisfied with daily functioning.

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