|
1000
|
Abstract/Summary
|
-
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Introduction</jats:title>
<jats:p>Perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are high-energy wrist injuries often linked to significant post-traumatic osteoarthritis. This study aims to determine whether PLD and PLFD yield different radiological outcomes following surgical treatment while identifying prognostic factors for worse outcomes.</jats:p>
</jats:sec><jats:sec>
<jats:title>Materials and methods</jats:title>
<jats:p>We retrospectively analyzed 51 patients treated for perilunate injuries between 2000 and 2022. Radiographic evaluation included postoperative carpal alignment, scapholunate distance, ulnar translocation, and postoperative arthrosis according to the Kellgren-Lawrence scale. Logistic regression models were used in the study. The analyzed explanatory variables included: type of injury (PLFD/PLD), Mayfield classification, capsulodesis, repair of intercarpal- and extrinsic ligaments, and number of wrist transfixations. The significance level was set at <jats:italic>p</jats:italic> ≤ 0.05. The calculations were performed with R (version 4.3.2).</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>Among 51 patients, the mean follow-up was 4.33 years (1-22.13), and the mean age was 37.76 years. PLFD accounted for 55% of cases. Patients in the PLD group were older at the time of injury (<jats:italic>p</jats:italic> = 0.0031) compared to PLFD. Older patients presented also with higher stages of perilunate instability (<jats:italic>p</jats:italic> = 0.0061). Midcarpal arthrosis was the most common site of wrist degeneration (58.8%). Ordinal logistic regression indicated that PLFD was associated with a lower risk of midcarpal arthrosis (OR = 0.293, <jats:italic>p</jats:italic> = 0.04), while a higher number of wrist transfixations increased the risk of advanced arthrosis (OR = 2.427, <jats:italic>p</jats:italic> = 0.02), The logistic regression model detected a positive effect of the number of wrist transfixations on lunate fovea arthrosis (<jats:italic>p</jats:italic> = 0.048). The number of wrist transfixations did not correlate with the number of fractures (<jats:italic>p</jats:italic> = 0.06), Mayfield classification (<jats:italic>p</jats:italic> = 0.16), or intraoperative reduction outcome (<jats:italic>p</jats:italic> = 0.6).</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>PLD and a greater number of wrist transfixations were associated with a higher risk of wrist arthrosis. Limiting wrist pinning to essential procedures may help prevent additional iatrogenic chondral lesions.</jats:p>
</jats:sec>
|
|
1000
|
Hinweis
|
-
DeepGreen-ID: 07bd9bd2f2664fbca5c8e3f847247900 ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
|
