Arch Hand Microsurg.  2018 Sep;23(3):158-165. 10.12790/ahm.2018.23.3.158.

Does the Morphological Type of the Lunate Affect Surgical Outcomes in Patients with Distal Radius Fractures?

• Kim SJ
• Jung KH
• Park HS
• Lee CH
• Choi WS
• Lee KH

• KMID: 2419450
• DOI: http://doi.org/10.12790/ahm.2018.23.3.158

Abstract

PURPOSE
We sought to compare the surgical results of distal radius fractures treated with volar locking plate (VLP) between two types of lunate. The hypothesis was that wrists with type II lunate might have worse surgical outcomes of distal radius fracture.
METHODS
Seventy patients with surgically treated distal radius fracture were included in this study. Morphology of the lunate was analyzed with computed tomography scans and simple radiographs. Patients with type I lunate were defined as having no articulation with the hamate. Patients with type II lunate were defined as having accessory articulation with the hamate. Surgical outcomes were assessed. Range-of-motion (ROM) and grip strength were measured at the final follow-up. All subjects were divided into two groups based on the lunate type and compared. Multiple logistic regression analysis was performed to find predictors for worse surgical outcome.
RESULTS
Mean age of the subjects was 53.66 years (17 to 74 years). Mean follow-up was 14.54 months (12 to 52 months). The mean flexion of the wrist joint was significantly lower in the group with type II lunate. The multiple logistic regression analysis demonstrated that the predictors for worse flexion of the wrist joint were patients with type II lunate, and insufficient restoration of normal volar tilt angle at final follow-up.
CONCLUSION
Type II lunate wrist joints had significantly lower ROM, compared with type I lunate wrist joints after surgical treatment of distal radius fracture using VLP.

Keyword

Distal radius fracture; Lunate type; Surgical outcome; Wrist range of motion

MeSH Terms

Follow-Up Studies
Hand Strength
Humans
Logistic Models
Radius Fractures*
Radius*
Wrist
Wrist Joint

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