par Lamraski, Guyve 
;Vancabeke, Michel ;Devos, Stéphane;Putz, Philippe
Référence Revue de chirurgie orthopédique et réparatrice de l'appareil moteur, 90, 6, page (533-541)
Publication Publié, 2004-10
;Vancabeke, Michel ;Devos, Stéphane;Putz, Philippe Référence Revue de chirurgie orthopédique et réparatrice de l'appareil moteur, 90, 6, page (533-541)
Publication Publié, 2004-10
Article révisé par les pairs
| Résumé : | Purpose of the study We performed a prospective study to search for arthrographic signs in favor of intracarpal ligament lesions occurring concomitantly with wrist fractures. We looked for a relationship between type of fracture and displacement and examined their impact on early functional outcome. Material and methods The series included 40 patients treated over a 1-year period. All 40 patients had a displaced wrist fracture requiring surgical treatment. A three-phase arthrography was performed during the initial operation in order to search for injuries involving the scapho-lunate, luno-pyramidal or triangular complex ligaments. A second arthrography was performed at the time the osteosynthesis material was removed. All patients were followed one year postperatively. Functional outcome was recorded at one year. Results Abnormal images were found in 57% of the patients at the first arthrography. Injury to the triangular complex predominated, followed by combined injuries. There was no statistical correlation between type of fracture, degree of displacement, and presence of ligament lesions (p > 0.05). Lesions of the triangular fibrocartilaginous complex (TFCC) were significantly increased (p = 0.04) in the event of intra-articular fracture. Age and gender did not influence ligament injury. At one year, the functional outcome was statistically comparable between patients with and without ligament injury. At the second arthrography, we observed only five cases where cure of the luno-pyramidal ligament had been achieved. Discussion Intracarpal ligament injuries associated with wrist fractures are frequent. Age had no effect on occurrence of ligament injury in our series, similar to findings reported by others. Likewise, the type of fracture had no effect. Data in the literature show that intra-articular fractures and highly-displaced fractures aggravate ligament injury. Our functional results at one year did riot demonstrate any significant difference in patients with and without ligament injury. A 3 or 5-year follow-up might provide further insight. Nevertheless, neglected scapho-lunate lesions still have a bad reputation in the literature, leading us to search for such lesions and to provide adapted treatment in all patients aged less than 50 years presenting a displaced fracture of the wrist. |
