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Compound Dorsal Dislocation of Lunate with Trapezoid Fracture

机译:梯形骨折的月牙复合背脱位

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摘要

We report about a dorsal dislocation of the lunate accompanied by a trapezoid fracture in a 41-year old male patient after a motorcycle accident. The lunate dislocation with no dorsal or volar intercalated segment instability (DISI, VISI) was diagnosed by x-ray whereas the trapezoid fracture was only diagnosable by computed tomography. A closed reduction and internal fixation of the lunate by two Kirschner wires was performed, the trapezoid fracture was conservatively treated. Surgery was followed by immobilization, intense physiotherapy and close follow-up. Even though complaints such as swelling and pain subsided during the course of rehabilitation, partial loss of strength and range of motion remained even after 16 months. In conclusion, a conservative treatment of trapezoid fractures seems to be sufficient in most cases. Closed reduction with K-wire fixation led to an overall satisfactory result in our case. For dorsal lunate dislocations in general, open reduction should be performed when close reduction is unsuccessful or DISI/VISI are observed in radiographs after attempted close reduction.
机译:我们报道了一名摩托车事故发生后的一名41岁男性患者的月牙背脱位并伴有梯形骨折。 X线检查可诊断出无背侧或掌侧插入节段性不稳定性的椎间盘脱位(DISI,VISI),而梯形骨折只能通过计算机断层扫描诊断。用两根克氏针进行闭合复位内固定术,保守治疗梯形骨折。手术后进行固定,严格的理疗和密切随访。尽管在康复过程中诸如肿胀和疼痛之类的不适症状消失了,但即使在16个月后,力量和运动范围仍然部分丧失。总之,在大多数情况下,保守治疗梯形骨折似乎已足够。在我们的病例中,采用K线固定术进行闭合复位可获得总体令人满意的结果。一般而言,对于背侧月牙脱位,当闭合复位不成功或尝试闭合复位后在射线照片中观察到DISI / VISI时,应进行闭合复位。

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