3.8 Article

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

Journal

CHIRURGIE DE LA MAIN
Volume 33, Issue 4, Pages 263-271

Publisher

ELSEVIER
DOI: 10.1016/j.main.2014.04.007

Keywords

Distal radius fracture; Volar plate; Minimally invasive surgery; Wrist arthroscopy

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This study reports the results of minimally invasive surgical treatment of distal radius fractures using a 15 mm 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 15 mm 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 contralatetal side. The mean palmar tilt was 8.8 degrees and the mean radial inclination 20.7 degrees. The radio-ulnar index was 1 mm with no DISI and the scapholunate gap was 1.5 mm. There were three cases of CRPS type I. Our results show that arthroscopy-assisted, minimally invasive surgery for distal radius fractures using a 15 mm incision results inn 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. (C) 2014 Elsevier Masson SAS. All rights reserved.

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