Treatment of Comminuted Intraarticular Fracture of Distal Radius with Arthroscopic Reposition of Fragments under External Fixation

Introduction. Use of arthroscopically assisted reduction of bone fragments in comminuted intraarticular fractures of the distal radius (DR) remains ambiguous. The purpose of the study was to determine the expediency and efficacy of arthroscopy in surgical treatment of comminuted DR frac- tures especially under conditions of wrist joint (WJ) external fixation. Patients and methods. Sixty eight patients (mean age 38±14.1 years) with comminuted intraar- ticular DR fractures (type B3-C3 by AO/ASIF) were operated on. In 34 out of them arthroscopic support of osteosynthesis was used. Treatment results were assessed in 3, 6 and 12 months by DASH questioner, X-ray examination data, grip strength and range of motion in WJ. Results. It was stated that WJ arthroscopy improved the diagnosis of joint injuries (injury of tri- angular fibro-cartilage complex was diagnosed in 29 (83.5%), scapholunate ligament - in 12 (35.5%), lunotriquetral ligament - in 4 (11.8%) cases) and the quality of bone fragments reposition (displacement of intraarticular fragments over 1 mm after primary reposition was arthroscopically diagnosed in 21 (61.8%) cases, statistically significant improves the early postoperative (first 3 months after surgery, p<0.05) but did not affect the long term treatment results.

intraarticular fracture, distal radius, arthroscopy, external fixation apparatus, articular surface, quality of reposition, long term result