Functional outcome of arthroscopic assisted fixation of distal radius fractures

Abstract

Background:Many studies in literature have supported the role of wrist arthroscopy as an adjunct to the stable fixation of unstable intraarticular distal radial fractures. This article focuses on the surgical technique, indications, advantages, and results using wrist arthroscopy to assess articular reduction and evaluates the treatment of carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries in conjunction with the stable fixation of distal radial fractures.Materials and Methods:We retrospectively evaluated 27 patients (16 males and 11 females), who underwent stable fixation of intraarticular distal radial fractures with arthroscopic evaluation of the articular reduction and repair of associated carpal injuries. As per the AO classification, they were 9 C 1, 12 C2, 2 C3, 3 B 1, and 1 B2 fractures. The final results were evaluated by modified Mayo wrist scoring system. The average age was 41 years (range: 18-68 years). The average followup was of 26 months (range 24-52 months).Results:Five patients needed modification of the reduction and fixation after arthroscopic joint evaluation. Associated ligament lesions found during the wrist arthroscopy were TFCC tears (n=17), scapholunate ligament injury (n=8), and luno-triquetral ligament injury (n=1). Five patients had combined injuries i.e. included TFCC tear, scapholunate and/or lunotriquetral ligament tear. There were 20 excellent, 3 good, and 4 fair results using this score.Conclusion:The radiocarpal and mid carpal arthroscopy is a useful adjunct to stable fixation of distal radial fractures.

Comparison of volar locking plates with external fixation and K-wires in arthroscopically assisted intra-articular distal radial fracture fixation

“…Our incidence of reposition of fragments at arthroscopy was higher than found in the literature. Despite the increased need to perform this in Group EF patients, our Group VLP patients also underwent this procedure more frequently than previously reported (Abe and Fujii, 2017;Burnier et al, 2018;Khanchandani and Badia, 2013;Ono et al, 2010Ono et al, , 2012.…”

Arthroscopic assisted treatment of distal radius fractures and concomitant injuries

“…The treatment of grade III injuries remains controversial. Several authors besides Geissler advocate K-wire pinning [33,[51][52][53][54][55]. However, there were no differences found in the subjective, objective, or radiographic outcome after grade III and grade I/II untreated tears associated with displaced DRFs [49].…”

Diagnostische Handgelenksarthroskopie und minimalinvasive therapeutische Möglichkeiten

“…Hier empfiehlt es sich, den Arm bis möglichst über den Ellenbogen nach proximal zu desinfizieren, um schließlich das Lochtuch bis knapp an die Oberarmblutsperre zu bringen. Nach Auswickeln des Armes mit einer gängigen Esmarch-Binde wird die Manschette bei Blutleere auf 75-100 mmHg höher als der systolische Wert des Patienten aufgeblasen, üblicherweise bei 250 mmHg [7].…”