Arthroscopic-assisted treatment of type C fractures of distal radius

Abstract

Objective To explore the clinical efficacy of internal fixation with wrist arthroscope assistance in type C fractures of distal radius.Methods Thirty-nine patients with distal radius type C fractures were involved.Under the wrist arthroccope monitoring,the fracture fragments of the distal radius were manually reduced so the articular surface was smooth and the displacement was less than 2 mm.Then the volar locking compression plate or K-wire external fixator was applied to fix the radius.The wrist joint ligaments were further examined under the arthroscope especially paying attention to the scapholunate ligament,lunotriquetral ligament and triangular fibrocartilage complex (TFCC).The corresponding cartilage and ligament damage was debrided under the wrist arthroscopy.Results Among the 39 cases of distal radius type C fracture,there were 4 cases of scapholunate ligament tear,3 cases of lunotriquetral ligament tear and 6 cases of TFCC tear.Postoperative follow-up ranged from 6 to 24 months with an average time of 11.3 months.Complete union of the fracture was achieved in all the patients about 8 to 16 weeks postoperatively,with a mean healing time of 11.4 weeks.The volar tilt and ulnar inclination angles were 8° to 17° and 16° to 26° respectively.Wrist functions were evaluated according to the Gartland-Werley system and rated as excellent in 23 cases,good in 11 cases and fair in 5 cases,with a good and excellent rate of 87.2％.Conclusion Wrist arthroscope-assisted treatment of type C fractures of the distal radius can not only restore the articular surface and reduce the occurrence of traumatic osteoarthritis,but also allows visualization of damages of TFCC and intra-articular ligaments.This enables early treatment so chronic wrist pain or wrist joint instability can be avoided. Key words: Radius fractures; Arthroscopy; Intra-articular