Handchir Mikrochir Plast Chir 2014; 46(05): 271-277
DOI: 10.1055/s-0034-1385926
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Arthroskopisch assistierte Versorgung dorsal dislozierter distaler intraartikulärer Speichenfrakturen – Technik und Ergebnisse

Arthroscopically Assisted Osteosynthesis of Dorsally Tilted Intraarticular Distal Radius Fractures – Technique and Results
M. Lutz
1   Unfallchirurgie, Landesklinikum Baden/Mödling, Mödling, Österreich
,
T. Wieland
1   Unfallchirurgie, Landesklinikum Baden/Mödling, Mödling, Österreich
,
C. Deml
2   Unfallchirurgie, Univ. Klinik Innsbruck, Innsbruck, Österreich
,
S. Erhart
2   Unfallchirurgie, Univ. Klinik Innsbruck, Innsbruck, Österreich
,
A. Rudisch
3   Radiologie, Univ. Klinik Innsbruck, Innsbruck, Österreich
,
T. Klestil
1   Unfallchirurgie, Landesklinikum Baden/Mödling, Mödling, Österreich
› Institutsangaben
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Publikationsverlauf

eingereicht 19. Juni 2014

akzeptiert 12. Juli 2014

Publikationsdatum:
07. Oktober 2014 (online)

Zusammenfassung

Die vorliegende Arbeit beschreibt die Indikation und Technik der arthroskopisch unterstützten Verplattung dorsal dislozierter intraartikulärer Radiusfrakturen. Dabei wird auf ein bewährtes Repositionsverfahren eingegangen, die Klassifikation von Begleitverletzungen beschrieben und deren Therapiemöglichkeiten diskutiert. Klinische und radiologische Ergebnisse einer Fallserie von 17 Patienten werden präsentiert. Die DASH- bzw. PRWE Werte lagen 2,5 Jahre nach der Operation bei 4,9 und 6,0. Die aktive Beweglichkeit in der Sagittalebene erreichte 123° und somit 87% der gesunden Gegenseite, in der Frontalebene wurden 51° erzielt, was 98% der Gegenseite entspricht. Die Unterarmdrehung war mit 163° und 97% annähernd seitengleich. Der dorsopalmare Gelenkwinkel zum Ausheilungszeitpunkt betrug durchschnittlich 6°, der radioulnäre Gelenkwin­kel 23° und die ulnare Varianz −1,2 mm. Der ska­pholunäre Gelenkspalt wurde mit 1,6 mm, der skapholunäre Gelenkwinkel mit 57° gemessen.

Abstract

The present paper describes the indication and application of an arthroscopically assisted osteosynthesis for distal radius fractures. Visualisation of articular incongruency is emphasised with special regard to articular fracture fragment reduction. In addition to that, classification of soft tissue injuries and treatment options are discussed. The final clinical and radiological results of 17 patients are presented: DASH and PRWE averaged 4.9 and 6.0 respectively. Active range of motion measured 123° for flexion/extension, 51° for radial and ulnar deviation and 163° for pronosupination, which is 87%, 98% and 97%, respectively, compared with the opposite wrist. Radial inclination at final follow-up was 23°, palmar tilt measured 6° and ulnar variance averaged −1.2 mm. The scapholunate gap at follow-up was 1.6 mm, and the scapholunate angle measured 57°.

 
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