Clinical effect evaluation of limited open reduction and internal fixation assisted by wrist arthroscopy for treatment of C type fracture of the distal radius

Abstract

Objective To explore the clinical effects of limited open reduction and internal fixation assisted by wrist arthroscopy for treatment of C type fracture of the distal radius. Methods From January 2014 to May 2016, 20 patients with C type fracture of the distal radius were treated by limited open reduction and internal fixation assisted by wrist arthroscopy. According to AO classification, 11 cases were C1 type fracture, 8 cases were C2 type, 1 case was C3 type. Among them 2 patients suffered from fractures of limbs and 1 patient complicated with visceral injuries. Results The average operation time was 65 min, and the average intraoperative blood loss was 50 ml. Intraoperative fluoroscopy was performed 2 to 6 times, with an average of 3 times. The X-ray and CT scan showed that the distal radius fracture was well restored with articular surface evenness being less than 2 mm. No screws were drilled into the joint cavity. The exudation at exposed Kirschner wire occurred in one case which turned better after Kirschner wire being pulled out 2 weeks postoperatively. The delayed wound healing at dorsal wrist occurred in one case. Postoperatively all the 20 patients were follow-up for 3 to 24 months, with an average of 12.4 months. The fracture healing time ranged from 10 to 16 weeks with an average of 11 weeks. The overall clinical efficacy was evaluated according to the Krimmer score. The results were excellent in 10 cases, good in 8 cases, fair in 1 case, and poor in 1 case. Conclusion Using limited open reduction and internal fixation assisted by wrist arthroscopy for treatment of C type fracture of the distal radius can achieve good clinical efficacy under minimally invasive and visual condition. It also reduces the use of C arm X-ray machine, and can evaluate the situation of ligament injury around the wrist during operation. Key words: Radius fractures; Fracture fixation,internal; Wrist arthroscopy; Assistant