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Chir Main. 2014 Sep;33(4):263-71. doi: 10.1016/j.main.2014.04.007. Epub 2014 Jul 9.

Minimally invasive surgery of distal radius fractures: A series of 20 cases using a 15mm anterior approach and arthroscopy.

Author information

  • 1Department of Hand Surgery, University Hospital of Strasbourg, 10, avenue Baumann, 67403 Illkirch cedex, France.
  • 2Department of Hand Surgery, University Hospital of Strasbourg, 10, avenue Baumann, 67403 Illkirch cedex, France. Electronic address: philippe.liverneaux@chru-strasbourg.fr.

Abstract

This study reports the results of minimally invasive surgical treatment of distal radius fractures using a 15mm incision with arthroscopic assistance. This was a retrospective series of 20 distal radius fractures in young or middle-aged patients caused by high-energy trauma and/or with articular involvement. The surgical procedure included two stages: fixation using a locking plate and then arthroscopy. The incision for plating was always 15mm long. Arthroscopy was used to reduce osteochondral fragments in two cases and to suture and pin six scapholunate lesions. After a mean follow-up of 4.3 months, the mean pain score was 1.9, QuickDASH was 24.6 and the mobility and grip strength were at least 75% of the contralateral side. The mean palmar tilt was 8.8° and the mean radial inclination 20.7°. The radio-ulnar index was -1mm with no DISI and the scapholunate gap was 1.5mm. There were three cases of CRPS type I. Our results show that arthroscopy-assisted, minimally invasive surgery for distal radius fractures using a 15mm incision results in a scar with good cosmetics and allows for easy reduction and fixation, and management of articular and ligament lesions. Its indications must take into account the functional demands placed on the wrist by the patient, energy of the trauma and fracture type.

LEVEL OF EVIDENCE:

IV.

Copyright © 2014 Elsevier Masson SAS. All rights reserved.

KEYWORDS:

Arthroscopie du poignet; Chirurgie mini-invasive; Distal radius fracture; Fracture distale du radius; Minimally invasive surgery; Plaque antérieure; Volar plate; Wrist arthroscopy

PMID:
25048257
[PubMed - in process]
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