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J Wrist Surg 2023; 12(01): 063-066
DOI: 10.1055/s-0041-1730344
Procedure

The Flexor Carpi Radialis Portal for Arthroscopy-Assisted Reduction of the Dorsal Ulnar Fragment in Distal Radius Fractures

Ricardo Kaempf de Oliveira
1   Department of Orthopaedics, Santa Casa de Misericórdia de Porto Alegre Hospital and Mãe de Deus Hospital, Porto Alegre, Brazil
,
João Pedro Farina Brunelli 
2   Hand and Microsurgery Service, Santa Casa de Misericórdia, São Paulo, Brazil
,
Marcio Aurelio Aita
3   ABC Medical School, Santo André, Brazil
,
Pedro Jose Delgado Serrano
4   Hospital Universitário HM Montepríncipe, Madrid, Spain
› Author Affiliations Funding None.
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Abstract

Background The importance of the dorsal ulnar fragment (DUF) for stability and articular congruence of the radius is widely recognized, and standard surgical techniques often fail to ensure its reduction.

Description of Technique We describe a modification of volar wrist portals for arthroscopic management of the DUF of the distal radius. It is made in an outside-in fashion in line with the flexor carpi radialis (FCR) approach for the distal radius. Through this volar portal, we achieve wide and direct visualization of the DUF, with the advantage of protecting important anatomic structures such as the FCR tendon, the radial artery, and the median nerve; all protected with the previously made volar approach for the distal radius. In addition, easy manipulation and reduction of the DUF is obtained with instrumentation through standard dorsal portals.

Patients and Methods We performed this procedure in 23 patients with distal radius fractures (DRF) with displaced DUF.

Results Early and late postoperative evaluation demonstrated intraoperative reduction maintenance and adequate range of motion, compatible with the usual findings of standard volar plating, with the benefit of anatomic reduction of the DUF.

Conclusion With our technique, volar plating associated with arthroscopy-assisted dorsal fragment specific fixation with dorsal standard and the FCR portals permits optimal surgical treatment of most DRFs.

Keywords

wrist arthroscopy - distal radius - fragment-specific fixation - volar wrist portals


Publication History

Received: 09 March 2021

Accepted: 13 April 2021

Article published online:
21 June 2021

© 2021. Thieme. All rights reserved.

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