Distal radius fracture. What we do not see with conventional approach? The role of arthroscopy.
DOI:
https://doi.org/10.25214/28056272.1644Keywords:
Radius fractures, Arthroscopy, Wrist Injuries, Intercarpal JointsAbstract
Introduction: Distal radius fractures (DRFs) are very common and they can frequently be associated with cartilage or ligament injuries. The purpose of this study is to identify and evaluate the incidence of associated injuries in intra-articular DRFs diagnosed by wrist arthroscopy.
Methods: This is a descriptive epidemiological study done on patients with intra-articular DRFs treated with open reduction and internal fixation (ORIF) with a volar locking plate assisted by wrist arthroscopy. Patients were included from January 2017 to December 2021 according to the Excel surgical database of Elbow and Hand Unit of Hospital. Patients with different lesions of DRFs, intra-articular fractures without arthroscopy assistance and extra-articular fractures were excluded.
Results: We identified 148 patients (81 men and 67 women) with an average age of 47 years (16-82). Concomitant lesions were observed in 99 patients (66%). The most frequent one is TFCC injury in 70 patients (47%). We observed lesions of an interosseous ligament in 62 patients (42%), 51 of scapholunate (SL) ligament and 37 of lunotriquetral (LT) ligament. Isolated injury of a structure was identified in 15 patients (10%) and both of them in 14 cases (9%). These lesions were treated in the arthroscopy procedure when that was indicated.
Conclusions: concomitant lesions were found in most of patients with intra-articular DRFs. The first one is TFCC injury, followed by intrinsic midcarpal ligament lesions. Wrist arthroscopy is necessary method to evaluate and treat associated lesions of TFCC and intrinsic ligaments.
Level of evidence: IV
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