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Arch Hand Microsurg > Volume 23(3); 2018 > Article
Archives of Hand and Microsurgery 2018;23(3):158-165.
Published online September 1, 2018.
Does the Morphological Type of the Lunate Affect Surgical Outcomes in Patients with Distal Radius Fractures?
Sung-Jae Kim1, Koo-Hyun Jung1, Hyun-Soo Park2, Chang-Hun Lee3, Wan-Sun Choi4, Kwang-Hyun Lee5
1Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
2Department of Orthopedic Surgery, Hanil Geneal Hospital, Seoul, Korea.
3Department of Orthopedic Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
4Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea.
5Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea.
Received: 8 May 2018   • Revised: 26 June 2018   • Accepted: 2 July 2018
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.

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.

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.

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.
Key Words: Distal radius fracture, Lunate type, Surgical outcome, Wrist range of motion

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