Influence of associated lesions of the intrinsic ligaments on distal radius fractures outcome.

Abstract

We aimed to evaluate the influence of associated scapholunate (SL) and/or lunotriquetral ligament (LT) injury on the outcome of distal radius fractures. This prospective study included 40 patients with surgically treated distal radius fracture. Wrist arthroscopy was used to identify associated lesions of the scapholunate and lunotriquetral ligaments and classify them according to Geissler. Patients were divided in two groups by presence (injured group) or absence (intact group) of associated injury of the SL and/or LT ligament. The patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaires were used to evaluate disability 3 and 6months after injury. Grip strength was also evaluated. Wrist arthroscopy identified SL and/or LT injury in 15 patients (37.5%). Mean total PRWE score for the intact group was 26.64 at 3months and 16.22 at 6months, and 50.47 (at 3months) and 20.7 (at 6months) for the group with ligament injury. Mean DASH scores were 26.03 and 13 at 3 and 6months for the intact group, and 49.5 and 24.11 for the injured group. Mann-Whitney test results showed significant difference for the PRWE and DASH scores and the grip strength for the two examined groups. Patients with distal radius fracture with associated intrinsic ligament injury had worse outcomes than did patients without associated ligamentous injury. Associated injuries of the SL and LT ligament should be considered when treating distal radius fractures, and wrist arthroscopy should be incorporated into the operative protocol.