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Jegal and Kim: Arthroscopically Assisted Reduction of Distal Radius Fractures
Review Article

J Korean Soc Surg Hand 2015;20(2):64-71.

Published online: 8 June 2015

DOI: https://doi.org/10.12790/jkssh.2015.20.2.64

Arthroscopically Assisted Reduction of Distal Radius Fractures

Midum Jegal1, Jong-Pil Kim1, 2

1Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea

2Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea

Correspondence to: Jong-Pil Kim Department of Orthopaedic Surgery, Dankook University College of Medicine, 359 Manghyang-ro, Dongnam-gu, Cheonan 330-715, Korea TEL: +82-41-550-3919 FAX: +82-41-556-3238 E-mail: kimjp@dankook.ac.kr

Received 7 June 201411 June 2015       Accepted 12 June 2015

Copyright © 2015 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Wrist arthroscopy has been used as an important adjunct procedure to distal radius fracture management. This procedure allows minimal surgical intervention and provides excellent visualization of the joint for anatomical restoration of articular fracture of the distal radius and early management of associated injuries. To many, it is still technically challenging to adequately perform arthroscopy in the distal radius fractures. With this review, we aimed to provide an updated arthroscopic technique in the management of distal radius fractures and potential pitfalls of this technique.

Keywords: Distal radius fracture, Arthroscopy

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Fig. 1.
Landmarks of dorsal wrist portals for distal radius fracture.
jkssh-20-64f1.tif
Fig. 2.
(A-C) Preoperative radiographs and arthroscopic image of 35-year-old male show intraarticular impaction and comminution of right distal radius fracture. (D) Arthroscopic image shows the restoration of the articular surface after reduction and K-wire fixation. (E) Arthroscopically assisted reduction and percutaneous pinning was performed. The ulnar styloid fracture was stabilized with a tension band wiring technique. (F) Postoperative 13-months radiographs show satisfactory healing.
jkssh-20-64f2.tif
Fig. 3.
(A) Preoperative radiographs of 54-year-old female show intra-articular comminuted fracture of left distal radius. (B) Intraoperative radiograph shows volar locking plate preset after anatomical alignment was regained under an image intensifier. (C, D) Arthroscopic images show the restoration of the articular surface after reduction. (E) The plate was securely fixed with locking screw after temporary K-wire fixation.
jkssh-20-64f3.tif
Table 1.
Arthroscopic classification of interosseous ligament injury
Grade Radiocarpal joint injury Midcarpal instability Step-off
I Hemorrhage of interosseous ligament No attenuation None None
II Incomplete partial or full-substance tear No attenuation Slight gap (less than width of a 1-mm probe) Midcarpal only
III Ligament attenuation Incomplete partial or small full-substance tear Probe can be passed between carpal bones Midcarpal and radiocarpal
IV Complete tear Gross instability 2.7-mm arthroscope can be passed between carpal bones Midcarpal and radiocarpal
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