Perilunate Management
Outcomes of Perilunate Injury Management: Open vs Arthroscopic Approach
Emory University
50 participants
Jul 3, 2023
INTERVENTIONAL
Conditions
Summary
Perilunate injuries can be debilitating injuries that involve the carpus. These can limit patients' functionality both acutely and long-term. Not only do their potential for nerve injury increase risk of lasting weakness and chronic pain, but their complex surrounding involving the carpus also leads to potential for misalignment when healing. The approach for treating perilunate injuries often relies on internal fixation, prompting the need for surgery. However, there is no clear recommendation for whether to pursue open or arthroscopic surgery as both offer benefits and pose risks. The aim of this study is to determine the similarities and differences in outcomes for management of perilunate injuries.
Eligibility
Inclusion Criteria2
- All adult patients (18 years old and older).
- Patients requiring surgical intervention for a perilunate injury will be consented and then randomly allocated to either open or arthroscopic surgery.
Exclusion Criteria4
- Prisoners will not be included in this study.
- Patients younger than 18 years old and pregnant patients will be excluded from this review.
- Patients who require specific surgical approach for their treatment, cannot be randomly allocated to one of the study arms, so will be excluded from this study.
- The study will not include data from minors, cognitively impaired individuals, or individuals who are vulnerable to coercion or under influence.
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Interventions
Arthroscopic approach involves smaller incision, offering less traumatic procedures and faster healing, but due to the limited space in this closed field with significant vasculature and nerve distribution, scoping has increased risk for iatrogenic injuries.
The open approach requires dissection of capsuloligamentous structures, which can lead to stiffness of the joint due to capsular scarring as it heals. However, it offers good visual field when treating the injury, allowing maneuverability to avoid iatrogenic soft tissue injuries.
Locations(1)
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NCT05824078