Surgical Outcomes and Prognostic Factors in Perilunate Dislocations and Transscaphoid Perilunate Fracture-Dislocations: A Retrospective Single-Center Study

Aim: Perilunate dislocations (PLD) and transscaphoid perilunate fracture-dislocations (TSPLFD) are severe wrist injuries typically resulting from high-energy trauma. Delayed diagnosis and delayed surgical treatment may adversely affect functional outcomes. This study aimed to evaluate functional outcomes and identify prognostic factors affecting clinical results in surgically treated perilunate injuries, particularly regarding diagnostic delay and timing of surgery.Material and Methods: A retrospective single-center study was conducted including patients who underwent surgical treatment for PLD or TSPLFD between 2015 and 2024. Demographic data, injury characteristics, surgical approach, and complications were recorded. Functional outcomes were assessed using the Mayo Wrist Score (MWS) and QuickDASH questionnaire. Patients were categorized based on surgical timing (<7 days vs ≥7 days) and presence of missed diagnosis.Results: Sixteen patients with 17 injured wrists were included. The mean age was 34.4 ± 10.7 years, and the mean time from injury to surgery was 6.2 ± 7.5 days. The mean MWS was 70.0 ± 16.0, and the mean QuickDASH score was 23.5 ± 22.1 at final follow-up. Early surgery (<7 days) was associated with significantly better functional outcomes compared with delayed surgery (MWS: 78.2 vs 55.0, p = 0.003; QuickDASH: 13.3 vs 42.3, p = 0.003). Missed diagnosis occurred in 47.1% of cases and showed a trend toward worse outcomes, although the difference was not statistically significant. Postoperative complications were observed in 41.2% of wrists, and salvage procedures were required in 11.7% of cases.Conclusion: Surgically treated perilunate injuries can achieve acceptable functional outcomes with anatomical reduction and stable fixation. However, early diagnosis and surgical intervention appear to be critical factors influencing functional recovery.