Analysis The Effect Of Conservative Treatment And Operative Treatment For Two Kinds Of Injury Dislocation Of Lunate

Objective:Respectively with comparison of Recovery and curative effect after Conservative Treatment or Operative treatment for the transscaphoid perilunate dislocation and the anterior dislocation of the lunate. Summarize the best choice of treatment for this two Common Types of dislocation injury of lunate.Methods:Retrospective analysis clinical datas of34transscaphoid perilunate dislocation and anterior dislocation of the lunate patients treated at department of orthopedics of Qilu hospital of shandong university since2008-2011.We given them Xray examination When the34patients were admitted to hospital. If we had difficulty to diagnosis,then given CT and Medical Image3d Reconstruction to patients.The34patients divided into four groups on the basis of different kind of types and therapeutic methods. Group A,10anterior dislocation of the lunate patients with Conservative Treatment. Group B,6anterior dislocation of the lunate patients with Operative treatment. Group C,5transscaphoid perilunate dislocation patients with Conservative Treatment. Group D,13transscaphoid perilunate dislocation patients with Operative treatment.All of patients in Group B dealt with Open reduction and exopexy.but for the Group D,we did open reduction and internal fixation.Give the34patients follow-up visit at regular intervals for1to3years,an average of2.5years.it is include the Wrist joint Cooney function score table:ROM, The Cooney wrist joint score, VAS, the power of gripping. Results:We have all34patients.The number of the anterior dislocation of the lunate patients is16.10patients with Conservative Treatment,6patients with Operative treatment. The number of the transscaphoid perilunate dislocation patients is18.5patients with Conservative Treatment,13patients with Operative treatment.We evaluate clinical effects of all kinds of therapeutic method.The result is,Group A:8are excellent,1are well,0is general,1is bad. Group B:4are excellent,1are well,1are general,no patient is bad. Group C:2are excellent,1are well,1are general,1are bad. Group D:12are excellent,1are well,0is general, no patient is bad.So far,we found in Group A,1patients has avascular necrosis of lunate,1has more than moderate pain,1has Sudeck atrophy.In the Group B,1patients has Sudeck atrophy. In the Group C,2patients have more than moderate pain,1hasSudeck atrophy. There is no patients have complication in the Group D. It is no statistical difference Cooney function score (p=0.754) and Excellent (χ2=0.356, P=0.604) rate Between Group A and Group B. There is a statistical significance at Cooney function score (p<0.001) and Excellent (χ2=5.716, P=0.044) rate Between Group C and Group D.Conclusions:Dislocation injury of lunate is a rare disease.we should do A properly preparedand get Perfect Radiographic inspection before treatment.Then we formulate an appropriate treatment plan.Most of the anterior dislocation of the lunate patients through Conservative Treatment can achieve Satisfactory effect. So do without operation in early stage to them.But for transscaphoid perilunate dislocation patients, Operative treatment is better than Conservative Treatment in early stage for them.