Perilunate Dislocations and Perilunate Fracture-Dislocations of the Carpus: A Retrospective Study of 16 Cases.

Introduction Perilunate dislocations and perilunate fracture-dislocations of the carpus are serious wrist injuries that have significant functional and socio-occupational consequences. The objective of this study was to describe the epidemiological, clinical, radiological, and therapeutic characteristics of these injuries and to evaluate their outcomes. Methods We conducted a retrospective study over five years, including patients over the age of 15 with a pure perilunate dislocation or a perilunate fracture-dislocation confirmed by standard wrist X-rays. Demographic, clinical, radiological, therapeutic, and follow-up data were collected and analyzed. Results Sixteen patients were included, including three patients (18.8%) with pure perilunate dislocation and 13 patients (81.2%) with perilunate fracture-dislocation. The mean age was 29 years. A marked male predominance was observed, with 14 male patients (87.5%) and two female patients (12.5%). Road traffic accidents were the leading mechanism of injury, accounting for nine cases (56.3%). Diagnosis was established using standard anteroposterior and lateral wrist radiographs. The mean time to treatment was 12 hours. All patients (100%) underwent open reduction and internal fixation. After a mean follow-up of 24 months, 12 patients (75%) had returned to their previous occupation, two patients (12.5%) required occupational reassignment, and two patients (12.5%) were unable to resume their previous occupational activity. The mean wrist flexion-extension arc corresponded to 72.5% of the contralateral side, grip strength reached 76% of the healthy side, and the mean Cooney score was 65/100. Conclusion Early diagnosis and prompt surgical management remain essential for achieving satisfactory functional outcomes following a perilunate injury. The time interval between the injury and reduction appears to be a major prognostic factor. Studies with larger sample sizes and longer follow-up are needed to evaluate long-term functional and radiographic outcomes.