Wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous internal fixation for the treatment of distal radius Fernandez type Ⅳ fractures

Abstract

To explore clinical effect of treatment for distal radius Fernandez type Ⅳ fractures by wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous, internal fixation. From January 2018 to December 2019, 11 patients distal radius Fernandez type Ⅳ fractures treated with wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous, internal fixation, including 8 males and 3 females, aged from 23 to 42 years old. The fracture were all calssified to type Ⅳ according to Fernandez classification. Postoperative fracture healing, activity of wrist joint and recovery of wrist joint were observed, postoperative visual analogue scale(VAS) at 12 months was used to evaluate pain of wrist joint, and Cooney wrist score scale was used to evaluate clinical effects. All the 11 patients were followed up from 12 to 13 months, and fractures were healed well for 4 to 6 months. Postoperative VAS at 12 months ranged from 0 to 3, palm tilt angle ranged from 0° to 15 °, ulnar drift angle ranged from 15° to 21°, wrist flexion and extension motion ranged from 110° to 162°, forearm rotation motion ranged from 165° to 178°. Cooney wrist joint comprehensive score ranged from 70 to 95 points, and 8 patients got excellent result, 2 good, and 1 fair. No osteoarthritis and complications occurred. Wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous, internal fixation for the treatment of Fernandez Ⅳ distal radius fractures could recevie effective fixation, and could receive satisfied clinical effect with system function exercise postoperative.