Arch Hand Microsurg 2018; 23(3): 158-165  
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
Correspondence to: Kwang-Hyun Lee
Department of Orthopedic Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
TEL: +82-2-901-3114, FAX: +82-2-2299-3774, E-mail: leegh@hanyang.ac.kr
Received: May 8, 2018; Revised: June 26, 2018; Accepted: July 2, 2018; Published online: September 1, 2018.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
Keywords: Distal radius fracture, Lunate type, Surgical outcome, Wrist range of motion


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