Arthroscopic-assisted treatment for athletes with distal radius fractures

Abstract

Introduction Many studies revealed soft tissue lesions were relatively common finding in young adult patients with distal radius fractures and arthroscopy appears to facilitate diagnosis. If these soft tissue lesions untreated, maybe causes the complications for the long-term outcome and have the inferior score results for high demand wrist. Objectives This presentation used percutaneous or open plating techniques augmented by simultaneous wrist arthroscopy to visualize the articular fractures and thus confirm the fracture alignment post-reduction, also assesses the concurrent associated ligament injuries. Methods Arthroscopy was used to help to reduce distal radius fractures and assess soft tissue injuries in 31 athletes (29 male and 2 female); including 11 baseball players, six basketball players, two gymnasts, seven tennis players, 2 rugby players and 3 football players. The average age of the patients was 28.2 years (range, 19–40). The fractures were treated by reduction under arthroscopic control and percutaneous or open fixation with implants. In our series, soft tissue injuries in wrist fracture of are common. The soft tissue lesions also treated at same operation including debridement, suture repairing or Kischner wires tranfixation. Results Night (29.0%) of the patients had scapholunate (SL) ligament injuries. Eight (23.7%) of the patients suffered lunotriquetral (LT) ligament injuries, and received ligament debridement or Kischner wires fixation of the joint and splinting. A further 10 (33.8%) of the patients exhibited chondral fractures. Additionally, the triangular fibrocartilage complex (TFCC) was torn in 13 (39.0%) of the patients. Finally, 9 (28.8%) of the patients suffered volar carpal ligament injuries. All fractures healed without malunion or nonunion, and at follow-up (more than 48 months), most patients (92%) displayed excellent and good results, based on Mayo modified wrist scores. Conclusion We believe that arthroscopic reduction may be considered for distal radius fractures because this approach can use a minimal operation to achieve acceptable restoration of fractures as well as assessment and management of soft tissue lesions in high demand athletes.