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Functional outcome of arthroscopic assisted fixation of distal radius fractures

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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.

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References

  1. Knirk JL, Jupiter JB. Intraarticular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am 1986;68:647–59.

    Article  CAS  Google Scholar 

  2. Trumble TE, Schmitt SR, Vedder NB. Factors affecting functional outcome of displaced intraarticular distal radius fractures. J Hand Surg Am 1994;19:325–40.

    Article  CAS  Google Scholar 

  3. Ono H, Katyam T, Furuta K, Suzuki D, Fujitani R, Akahane M. Distal radius fracture arthroscopic intraarticular gap and step-off measurement after open reduction and internal fixation with a volar locked plate. J Orthop Sci 2012;17443–9.

    Google Scholar 

  4. Abboudi J, Culp RW. Treating fractures of the distal radius with arthroscopic assistance. Orthop Clin North Am 2001;32:307–15.

    Article  CAS  Google Scholar 

  5. Chen AC, Chan YS, Yuan LJ, Ye WL, Lee MS, Chao EK. Arthroscopically assisted osteosynthesis of complex intraarticular fractures of the distal radius. J Trauma 2002;53:354–9.

    Article  Google Scholar 

  6. Edwards CC, Haraszti CJ, McGillivary GR, Gutlow AP. Intraarticular distal radius fractures: Arthroscopic assessment of radiographically assisted reduction. J Hand Surg Am 2001;26:1036–41.

    Article  Google Scholar 

  7. Kuzma GR, Kuzma KR. Distal radius fractures arthroscopic assited fixation. Oper Tech Sports Med 2010;18:189–96.

    Article  Google Scholar 

  8. Dantuliri PK, Gillon T. Current treatment of distal radiais fractures: Arthroscopic assisted fracture reduction of distal radius fractures. Oper Tech Orthop 2009;19:88–95.

    Article  Google Scholar 

  9. Badia A, Khanchandani P. Volar plate fixation. In: Slutsky DJ, Osterman AL, editors. Distal radial fractures and carpal injuries: The cutting edge. 1st ed. Philadelphia: Saunders, Elsevier; 2008. pp. 149–56.

    Google Scholar 

  10. Lutsky K, Boyer MI, Steffen JA, Goldfarb CA. Arthroscopic assessment of intraarticular fractures after open reduction and internal reduction and internal fixation from a volar approach. J Hand Surg 2008;33A: 476–84.

    Article  Google Scholar 

  11. Slutsky DJ. Current innovations in wrist arthroscopy. J Hand Surg 2012;37A: 1932–41.

    Article  Google Scholar 

  12. Varitimidis SE, Basdekis GK, Dailiana ZH, Hanted ME, Bargiotas K, Malizos K. Treatment of intraarticular fractures of the distal radius: Fluoroscopic or arthroscopic reduction? J Bone Joint Surg 2008;90B: 778–85.

    Article  Google Scholar 

  13. Doi K, Hattori Y, Otsuka K, Abe Y, Yammamoto H. Intraarticular fractures of the distal aspect of the radius: arthroscopically assisted reduction compared with open reduction and internal fixation. J Bone Joint Surg Am 1999;81:1093–110.

    Article  CAS  Google Scholar 

  14. Kordasiewicz B, Podgórski A, Klich M, Michalik D, Chaberek S, Pomianowski S. Arthroscopic assessment of intraarticular distal radius fractures-results of minimally invasive fixation. Ortop Traumatol Rehabil 2011;13:369–86.

    Article  Google Scholar 

  15. Whipple TL. The role of arthroscopy in the treatment of intraarticular wrist fractures. Hand Clin 1995;11:13–8.

    PubMed  CAS  Google Scholar 

  16. Del Piñal F. Treatment of explosion-type distal radius fractures. In: Del Pinal F, Mathoulin C, Luchetti C, editors. Arthroscopic management of distal radius fractures. Berlin: Springer Verlag; 2010. p. 41–65.

    Chapter  Google Scholar 

  17. Geissler WB, Freeland AE, Savoie FH, McIntyre LW, Whipple TL. Intracarpal soft-tissue lesions associated with an intraarticular fracture of the distal end of the radius. J Bone Joint Surg Am 1996;78:357–65.

    Article  CAS  Google Scholar 

  18. Forward DP, Lindau TR, Melsom DS. Intercarpal ligament injuries associated with fractures of the distal part of the radius. J Bone Joint Surg 2007;89A: 2334–340.

    Article  Google Scholar 

  19. Geissler WB. Arthroscopically assisted reduction of intraarticular fractures of the distal radius. Hand Clin 1995;11:19–29.

    PubMed  CAS  Google Scholar 

  20. Muller ME, Allgower M, Schneider R, Willenegger H. Manual of internal fixation: Techniques recommended by the AO group. 3rd ed. New York: Springer; 1990. p. 118–50.

    Google Scholar 

  21. Stark RH. Neurologic injury from axillary block anesthesia. J Hand Surg Am 1996;21:319–26.

    Article  Google Scholar 

  22. Bouaziz H, Narchi P, Mercier FJ, Khoury A, Poirier T, Benhamou D. The use of a selective axillary nerve block for outpatient hand surgery. Anesth Analg 1998;86:746–8.

    Article  CAS  Google Scholar 

  23. Agee JM, McCarroll HR Jr, Tortosa RD, Berry DA, Szabo RM, Peimer CA. Endoscopic release of the carpal tunnel: A randomized prospective multicenter study. J Hand Surg Am 1992;17:987–95.

    Article  CAS  Google Scholar 

  24. Badia A. Median Nerve Compression Secondary to Fractures of Distal Radius. In: Luchetti R, Amadeo P, editors. Carpal Tunnel Syndrome. Berlin: Springer; 2006. p. 247–52.

    Google Scholar 

  25. Orbay JL, Badia A, Indriago IR, Infante A, Khouri KR, Gonzalez E, et al. The extended flexor carpi radialis approach: A new perspective for the distal radius fracture. Tech Hand Upper Extrem Surg 2001;5:204–11.

    Article  CAS  Google Scholar 

  26. Palmer AK. Triangular fibrocartilage complex lesions: A classification. J Hand Surg Am 1989;14:594–606.

    Article  CAS  Google Scholar 

  27. Badia A, Khanchandani P. Suture welding for arthroscopic repair of Peripheral triangular fibrocartilage complex tear. Tech Hand Upper Extrem Surg 2007;11:45–50.

    Article  Google Scholar 

  28. Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP, Linscheid RL. Scaphoid malunion. J Hand Surg Am 1989;14:679–87.

    Article  CAS  Google Scholar 

  29. Ruch DS, Valle J, Poehling GG, Smith BP, Kuzma GR. Arthroscopic reduction versus fluoroscopic reduction in the management of intraarticular distal radius fractures. Arthroscopy 2004;20:225–30.

    Article  Google Scholar 

  30. Weiss AP, Akelman E, Lainbiase R. Comparison of the findings of triple injection cinearthrography of the wrist with those of arthroscopy. J Bone Joint Surg Am 1996;78:348–56.

    Article  CAS  Google Scholar 

  31. Rominger MB, Bernreuter WK, Kenney PJ, Lee DH. MR imaging of anatomy and tears of wrist ligaments. Radiographics 1993;13:1233–48.

    Article  CAS  Google Scholar 

  32. Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radius fractures. J Hand Surg Am 2000;25:464–8.

    Article  CAS  Google Scholar 

  33. Shih JT, Lee HM, Hou YT, Tan CM. Arthroscopically-assisted reduction of intraarticular fractures and soft tissue management of distal radius. Hand Surg 2001;6:127–35.

    Article  CAS  Google Scholar 

  34. Osterman AL, Vanduzer ST. Arthroscopy in the treatment of distal radial fractures with assessment and treatment of associated injuries. Atlas Hand Clin 2006;11:231–41.

    Google Scholar 

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Authors and Affiliations

  1. Badia Hand to Shoulder Center, Miami, Florida, USA

    Alejandro Badia

  2. Department of Orthopaedics, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthigram, Puttaparthi, Andhra Pradesh, 515 134, India

    Prakash Khanchandani

Authors
  1. Prakash Khanchandani
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  2. Alejandro Badia
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Correspondence to Prakash Khanchandani.

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Khanchandani, P., Badia, A. Functional outcome of arthroscopic assisted fixation of distal radius fractures. IJOO 47, 288–294 (2013). https://doi.org/10.4103/0019-5413.109872

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