Arthroscopic reduction versus fluoroscopic reduction in the management of intra-articular distal radius fractures.

Published

Journal Article

PURPOSE: Although arthroscopy offers an unparalleled view of intra-articular pathology, its use in the treatment of intra-articular distal radius fractures remains controversial. This study was designed to compare functional and radiologic outcomes of arthroscopically assisted (AA) versus fluoroscopically assisted (FA) reduction and external fixation of distal radius fractures. TYPE OF STUDY: Retrospective, case-matched comparison of 2 different procedures. METHODS: Between January 1995 and December 1999, 15 patients with comminuted intra-articular distal radius fractures underwent AA external fixation and percutaneous pinning. Fifteen patients underwent external fixation and FA reduction and pinning. Patients in both groups were matched for fracture pattern and age. RESULTS: Follow-up evaluation consisted of an evaluation of grip strength and range of motion as well as radiographic evaluation of palmar tilt, radial shortening, stepoff, and degenerative changes. Health-related quality of life outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Patients who underwent AA surgery had significantly improved supination compared with those who underwent FA surgery (88 degrees v 73 degrees; P =.02). AA reduction also resulted in improved wrist extension (mean, 77 degrees v 69 degrees; P =.01) and wrist flexion (mean, 78 degrees v 59 degrees; P =.02). Radial shortening, Knirk and Jupiter congruity grades, and DASH scores were similar for both groups. CONCLUSIONS: AA reduction and fixation of intra-articular distal radius fractures permits a more thorough inspection of the ulnar-sided components of the injury. At follow-up evaluation, patients who underwent AA procedures had a greater degree of supination, flexion, and extension than patients undergoing FA surgery. LEVEL OF EVIDENCE: Level II prospective cohort study.

Full Text

Duke Authors

Cited Authors

  • Ruch, DS; Vallee, J; Poehling, GG; Smith, BP; Kuzma, GR

Published Date

  • March 2004

Published In

Volume / Issue

  • 20 / 3

Start / End Page

  • 225 - 230

PubMed ID

  • 15007310

Pubmed Central ID

  • 15007310

Electronic International Standard Serial Number (EISSN)

  • 1526-3231

Digital Object Identifier (DOI)

  • 10.1016/j.arthro.2004.01.010

Language

  • eng

Conference Location

  • United States