Wrist arthroscopy in the management of articular distal radius fractures.

Publisher: Oxford University Press Country of Publication: England NLM ID: 0376542 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-8391 (Electronic) Linking ISSN: 00071420 NLM ISO Abbreviation: Br Med Bull Subsets: MEDLINE

Publication: 2001- : London : Oxford University Press
Original Publication: London.

Arthroscopy*/methods ; Fracture Fixation, Internal*/methods; Intra-Articular Fractures/*surgery ; Ligaments, Articular/*surgery ; Radius Fractures/*surgery ; Wrist Injuries/*surgery; Fracture Healing ; Humans ; Intra-Articular Fractures/diagnostic imaging ; Intra-Articular Fractures/physiopathology ; Ligaments, Articular/injuries ; Radius Fractures/diagnostic imaging ; Radius Fractures/physiopathology ; Treatment Outcome ; Wrist Injuries/physiopathology

Introduction: Fractures of the distal radius account for 15% of all fractures. The use of arthroscopy is increasingly popular in the last years, with the goal to achieve a better anatomical reduction of the articular fragments.
Sources of Data: We searched the literature on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'wrist', 'distal radial fracture', 'distal radius fracture' and 'arthroscopy'. Twenty-eight studies were identified. The quality of the studies was assessed using the Coleman Methodological Score.
Areas of Agreement: Arthroscopy allows to detect intra-articular, ligamentous and triangular fibrocartilage complex injuries in an acute setting with a better prognosis. Arthroscopy increases the quality of the intra-articular reduction compared to fluoroscopy.
Areas of Controversy: The main limitation of the selected studies is the short follow-up: the average follow-up in 20 studies was 12 months, a period long enough to assess functional outcomes, but not to assess the occurrence of post-traumatic degenerative changes and their impact on function. Better stratification of the fracture population is needed.
Growing Points: The shorter recovery time and the low incidence of adverse effects are the main advantages of this new technology.
Areas Timely for Developing Research: There is need to perform randomized controlled trials reporting on the use of volar locking plates as, at the present time, they are the standard management for these fractures. In addition, the different pattern of fracture should be better classified to manage the patients who will benefit after the management.
(© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Keywords: distal radial fracture; distal radius fracture; wrist arthroscopy

Date Created: 20160825 Date Completed: 20170925 Latest Revision: 20181101

20240829

10.1093/bmb/ldw032

27554281