ABSTRACT

Arthroscopically assisted reduction of distal radius fractures was accomplished with fluoroscopic control to obtain precise reduction. The frequency and severity of accompanying intra-articular pathologies were investigated, and functional outcomes were prospectively evaluated.

Twelve adult patients with irreducible or unstable intra-articular distal radius fractures were included. Wrist joints were distracted by bridging external fixators. Articular surfaces restored arthroscopically and stabilized with K-wires under fluoroscopic controls fixators were locked. Clinical evaluations were performed with disabilities of the arm, shoulder and hand (DASH) questionnaire, Sarmiento modification of the Gartland and Werley score (GWSM) and modified Mayo wrist score (MWSM).

Triangular fibrocartilage complex (TFCC) tears in six (50%) patients and scapholunate interosseous ligament (SLIL) lesions in five patients (41.6%) were observed. Four TFCC tears accompanied the SLIL lesions. The follow-up period was 1.5 years (16-23 months). No dorsal angulation, loss of radial inclination, and loss of radial length were found at the final radiographs. The DASH scores were approximately 6.1 (0-15.4). The GWSM results were excellent in nine and good in three patients, and the MWSM results were excellent in eight and good in four patients.

Anatomical articular surface restoration of the distal radius can be achieved by arthroscopically assisted osteosynthesis under fluoroscopic control. Arthroscopy can be used to determine the intra-articular ligamentous and chondral lesions, and debridement or repair can also be performed when needed to avoid long-term complications.

Keywords: Intra-articular, distal radius, fracture, arthroscopically assisted fixation, external fixator