Abstract
Articular distal radius fractures (DRFs) have increased in incidence in recent years,
especially among the economically active population. Most of the treatment approaches
are based on plain X- rays, and do not give us any information on how to treat these
fractures. In the search for solutions with greater precision in diagnosis, in reducing
the joint surface of the fracture, and envolving minimally-invasive techniques, we
found arthroscopy as the main tool for these patients. Therefore, an enhanced understanding
of the biomechanics of the different types of fracture associated with ligamentous
lesions should facilitate the right decision regarding the treatment. The present
paper aims at providing a management-oriented concept to diagnose and treat ligamentous
lesions associated with intra-articular DRFs based on a arthroscopy-assisted procedure,
and showing the objective and patient-reported outcomes and a new classification.
The objective and patient-reported outcomes were: the mean range of motion (ROM) was
of 94.80% on the non-affected side; the mean score on the abbreviated version of the
Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) was of 3.6 (range:
1 to 12). The score on the Visual Analog Scale (VAS) was of 1.66 (range: 1 to 3).
Complications were observed in 2 (13.33%) patients: extensor tendon synovitis in 1
patient, and a limitation (stiffness) in ROM in 1 patient, both treated with wrist
arthroscopy release. The mean time until the return to work was of 6.4 weeks. In patients
with unstable intra-articular DRFs associated with ligamentous lesions, the fixation
of specific osseous-ligamentous fragments and ligamentous repair/reconstruction by
wrist arthroscopy prove to be a safe and reliable treatment. The clinical and functional
results predict that the patients can return to work more quickly.
Keywords
distal radius fracture - treatment-oriented classification - ligament lesion
