Arthroscopic-assisted Open Reduction And Volar Plate Fixation To Treat The Comminuted Intra-articular Fracture Of The Distal Radius

Objective:To report the clinical outcome of arthroscopic-assisted open reduction and volar plate fixation for treating the comminuted intra-articular fracture of the distal radius.Methods:From September 2014 to May 2017,15 patients with comminuted intra-articular fracture of distal radius were studied retrospectively in our department.Among them,10 were male and 5 were female.Age was from 31 to 57,averaged 41.6.Before the surgery,all the patients were examined by X-ray and the CT scan to identify that all fractures were type C2 or C3 according to AO classification.All 15 patients were treated by arthroscopic-assisted open reduction and volar plate fixation.The radiographic outcome was obtained on the X-ray performed at the latest follow-up while measuring the range of motion and the grip strength of the wrist.Results:The follow-up was 5 to 12 months.The time for fracture healing was from 7 to 11 weeks,averaged 8.4 weeks.The volar tilting was from 8°to 17°,averaged 13°and the radial inclination was from 19°to 26°,averaged 22.4°.The average range of motion of the wrist was 60°(56°to 67°)of flexion and 56°(48°to 70°)of the extension,and the mean grip strength was 81%(65% to 90%).According to Garland and Worley’s criteria,the outcome was excellent in 9 patients and good in 5 patients,the excellent and good rate was 99.3%.One patient appeared slight median nerve compression symptom,the index and middle finger feeling slightly numb.The symptom disappeared when removing the volar plate after the fracture healing.Conclusions:Arthroscopic-assisted open reduction and volar plate fixation to treat the comminuted intra-articular fracture of distal radius can manage the associated soft tissue,such as TFCC,scapholunate or lunotriquetral ligaments,damage while providing better anatomic reduction,which could reduce the possibility of wrist instability and regional pain syndrome.Our study showed that arthroscopic-assisted open reduction and volar plate fixation is a reliable,effective and practical method to treat the comminuted intra-articular fracture of distal radius.