Abstract
The optimal management of perilunate injuries is challenging and remains controversial. It is our philosophy to employ the method that is associated with the least surgical morbidity in order to achieve a successful outcome. Open surgery involves extensive soft tissue dissection, which could lead to capsular scarring, joint stiffness and further impair the already tenuous vascular supply to the scaphoid and intrinsic ligaments. Forceful closed manual reduction in the capitolunate joint can lead to further articular damage of the capitate, an area already weakened or injured during the initial injury. Arthroscopic-assisted reduction always occurs under direct vision and requires no manoeuvres that may compromise the cartilage. Arthroscopic treatment of such injuries offers a precise alternative to assist with anatomic reduction and percutaneous fixation with minimal soft tissue disruption, which may improve healing and wrist mobility. It also offers the ability for complete radiocarpal and midcarpal joint inspection to identify and treat concomitant injuries, such as carpal fractures and TFCC tears. The early outcomes of arthroscopic management of perilunate injuries are encouraging. Despite the technical challenges, this minimally invasive approach is clinically reliable and offers a favourable alternative to the traditional open treatment of this condition.