Clinical Research Of Minimally Invasive Treatment For Trans-radial Styloid Perilunate Fracture-dislocations Of The Carpus

Objective: To introduce minimally invasive surgery for a special type of wrist injury,trans-radial styloid perilunate fracture-dislocations of the carpus,and evaluate its curative effect.Methods: Retrospect 6 cases of trans-radial styloid perilunate fracture-dislocations,have been treated in our hospital from January 2015 to December 2017.All of the 6 cases were treated under the C-arm,Kirschner wire poking reset,and percutaneous Kirschner wire fixation,ligaments were repaired by miniature anchor under the small incision.Short arm plaster fixation after operation and assisted with functional exercises.Imaging evaluation were given during the follow-up period,and evaluated the wrist function with Cooney scoring method.4-20 months of follow-up,mean 12 months.Results: Preoperative palmar flexion was 0 °-5°,mean 1.3 °,dorsiflexion was 8°-23°,mean 14.8°,ulnar deviation 1°-7°,mean 4.5°,Radial deviation 0°-3°,mean 0.8°,and postoperation palmar flexion was 20°-70 °,mean 54°,dorsiflexion was 35°-63 °,mean 52.7 °,ulnar deviation 18°-26°,mean 22.3°,Radial deviation 5°-15°,mean 11°in the 6 cases.There were no aseptic necrosis of carpus,traumatic arthritis of wrist and carpal instability in all 6 cases,only 1 case had pain and median nerve injury symptoms.Although the range of wrist joint activity had a difference in the ratio of the side to the healthy side,there were only 1 case fair,and the rest were good under the Cooney score.Patient satisfaction is high.Conclusions: 1.Throwing Kirschner wire poking reset,percutaneous Kirschner wire fixation,and repairing ligaments by miniature anchor under the small incision and the C-arm is a secure,safe and effective method for the treatment of trans-radial styloid perilunate fracture-dislocations;2.Improving the repair of the ligaments in the wrist is a key factor in maintaining the stability of the wrist;3.Minimally invasive treatment of trans-radial styloid perilunate fracture-dislocations can reduce the injury of wrist ligament,protect the blood supply of carpal bones,and reduce the incidence of aseptic necrosis of carpal bones.