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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2021; 49(01): 024-036
DOI: 10.1055/s-0041-1730393
Original Article | Artículo Original

Arthroscopic Management of Intra-articular Ligament Lesions on Distal Radius Fractures

Article in several languages: English | español
Marcio Aurelio Aita 
1   Faculdade de Medicina do ABC, Santo André, São Paulo, SP, Brazil
,
Ricardo Kaempf 
2   Santa Casa de Misericórdia, Porto Alegre, RS, Brazil
,
Bruno Gianordoli Biondi 
1   Faculdade de Medicina do ABC, Santo André, São Paulo, SP, Brazil
,
Gary Alan Montano
1   Faculdade de Medicina do ABC, Santo André, São Paulo, SP, Brazil
,
Fernando Towata
1   Faculdade de Medicina do ABC, Santo André, São Paulo, SP, Brazil
,
Gustavo Luis Gomez Rodriguez 
3   Hospital Britanico de Buenos Aires, Argentina
,
Gustavo Mantovani Ruggiero 
4   Università Degli Studi Di Milano, Orthopaedics Department, Milano, MI, Italy
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Abstract

Articular distal radius fractures (DRFs) have increased in incidence in recent years, especially among the economically active population. Most of the treatment approaches are based on plain X- rays, and do not give us any information on how to treat these fractures. In the search for solutions with greater precision in diagnosis, in reducing the joint surface of the fracture, and envolving minimally-invasive techniques, we found arthroscopy as the main tool for these patients. Therefore, an enhanced understanding of the biomechanics of the different types of fracture associated with ligamentous lesions should facilitate the right decision regarding the treatment. The present paper aims at providing a management-oriented concept to diagnose and treat ligamentous lesions associated with intra-articular DRFs based on a arthroscopy-assisted procedure, and showing the objective and patient-reported outcomes and a new classification. The objective and patient-reported outcomes were: the mean range of motion (ROM) was of 94.80% on the non-affected side; the mean score on the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) was of 3.6 (range: 1 to 12). The score on the Visual Analog Scale (VAS) was of 1.66 (range: 1 to 3). Complications were observed in 2 (13.33%) patients: extensor tendon synovitis in 1 patient, and a limitation (stiffness) in ROM in 1 patient, both treated with wrist arthroscopy release. The mean time until the return to work was of 6.4 weeks. In patients with unstable intra-articular DRFs associated with ligamentous lesions, the fixation of specific osseous-ligamentous fragments and ligamentous repair/reconstruction by wrist arthroscopy prove to be a safe and reliable treatment. The clinical and functional results predict that the patients can return to work more quickly.

Keywords

distal radius fracture - treatment-oriented classification - ligament lesion


Publication History

Received: 19 August 2020

Accepted: 04 February 2021

Article published online:
02 July 2021

© 2021. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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