[Interest in wrist arthroscopy for treatment of articular fractures of the distal radius: report of 27 cases]

Abstract

We report our results of treatment of intra articular distal radius fracture assisted by wrist arthroscopy. Twenty six patients (15 men and 11 women) were treated using this technique. All the patients were operated on under regional anaesthesia, the elbow flexed to 90 degrees, and in-line traction applied using "Japanese" fingers traps (4 to 6 kgs). After articular cleansing, reduction under arthroscopic and fluoroscopic control was carried out using K-wires. All fractures were intra articular and in four cases of fractures with four fragments, it was necessary to combine a volar plate with the K-wires. There were 21 associated ligament injuries (seven TFCC tears, four lunotriquetral ligament injuries and ten scapholunate injuries of which four necessitated pinning). Our average follow-up time was 16 months (6-26 months). There was absence of pain in 23 cases and the results were good for wrist motion and strength. We did not experienced any severe secondary displacement. Eighteen excellent, seven good results and one average result were obtained. The quality of these functional and anatomical results seems to be directly linked to the quality of reduction obtained under arthroscopy and the quality of internal fixation carried out under traction.