Elsevier

Hand Clinics

Volume 33, Issue 4, November 2017, Pages 659-668
Hand Clinics

Arthroscopic-Assisted Reduction of Intra-articular Distal Radius Fracture

https://doi.org/10.1016/j.hcl.2017.07.011Get rights and content

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Key points

  • Wrist arthroscopy is an efficient adjunct for intra-articular distal radius fracture fixation. However, performing wrist arthroscopy during the plate fixation is troublesome with the vertical traction applied and released.

  • To facilitate the procedure, the authors developed a surgical technique, plate presetting arthroscopic reduction technique (PART), using a palmar locking plate. Since July 2005, they have performed PART for 248 intra-articular distal radius fractures with good and excellent

Indications/contraindications

Although various factors affect the prognosis of treatment of DRF, accurate restoration of the alignment of the radius with its carpal and ulnar articulations, anatomic reduction of articular surface, and treatment of associated intra-articular soft tissue injury are the most important factors. Wrist arthroscopy has the advantage not only of a direct visualization of the reduction of intra-articular fragments but also of the possibility to manage intra-articular soft tissue injuries.

Preoperative Planning

Besides the standard posteroanterior and lateral radiographs, oblique radiographs at 45° of supination and pronation of the forearm, and computed tomography (CT), including 3-dimensional (3D) reconstruction, are valuable in deciding a surgical strategy for the treatment of DRF (Fig. 1).

Preparation and Patient Positioning

The arthroscopy monitor, the fluoroscopy and the arthroscopic equipment, including a small-diameter arthroscope with a 30° field of vision, a shaver, and a radiofrequency device must be positioned conveniently (

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References (22)

  • K.C. Chung et al.

    Treatment of unstable distal radius fractures with the volar locking plate systems

    J Bone Joint Surg

    (2006)
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