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J Wrist Surg 2025; 14(01): 075-081
DOI: 10.1055/s-0043-1776115
Procedure

Arthroscopic-assisted Distal Radius Fracture Fixation for Dorsoulnar Corner Fragments Using a Locked, Hooked Kirschner-Wire Technique

Mark Ross 
1   Brisbane Hand and Upper Limb Research Institute, Brisbane, Queensland, Australia
2   Orthopaedic Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
3   Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
,
Matthew J. White
4   Macquarie Hand Unit, Suite 403 Macquarie University Clinic, 2 Technology Place, Macquarie University Hospital, Sydney, New South Wales, Australia
,
Nicholas Smith
4   Macquarie Hand Unit, Suite 403 Macquarie University Clinic, 2 Technology Place, Macquarie University Hospital, Sydney, New South Wales, Australia
› Author Affiliations
Funding N.S. receives royalties from NewClip Technics, Nantes, France for the Stepwise Distal Radius system. M.R. receives royalties from NewClip Technics, Nantes, France for the K-lock.
› Further Information
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Abstract

Background Distal radius fractures with dorso-ulnar corner fragments (DUC) pose a surgical challenge due to limited visualization and the risk of hardware prominence. Traditional approaches often result in inadequate reduction and fixation, leading to suboptimal clinical outcomes.

Description of Technique In this study, we introduce an arthroscopic-assisted approach for the fixation of distal radius fractures with DUC fragments. The technique utilizes locked, hooked K-wires to provide a low-profile dorsal capturing mechanism. We outline the step-by-step procedure, which includes pre-operative planning, volar plate application, and arthroscopic reduction of DUC fragments.

Materials and Methods We applied this technique to a 60-year-old female patient with an unstable intra-articular distal radius fracture and a DUC fragment. Closed reduction was initially attempted, followed by arthroscopic-assisted reduction and internal fixation using the locked, hooked K-wire technique.

Results Our technique has demonstrated its ability to withstand early movement rehabilitation protocols without fixation loss, enabling early mobilization. A custom thermoplastic splint was worn for 6 weeks, with favorable supination/pronation and wrist flexion/extension outcomes at clinical review.

Conclusions Arthroscopic-assisted fixation with locked, hooked K-wires offers a reliable solution for accurately reducing challenging DUC fragments in distal radius fractures. This approach complements standard distal radius fixation systems, providing a low-profile dorsal capturing mechanism and addressing the issue of hardware prominence, ultimately improving clinical outcomes.

Keywords

wrist - radius - fracture - arthroscopic - dorsoulnar corner


Publication History

Received: 05 June 2023

Accepted: 20 September 2023

Article published online:
07 November 2023

© 2023. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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