J Wrist Surg 2021; 10(02): 102-110
DOI: 10.1055/s-0040-1719039
Scientific Article

Comparing Outcomes between Arthroscopic-Assisted Reduction and Fluoroscopic Reduction in AO Type C Distal Radius Fracture Treatment

1   Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
,
Kam Yiu Adrian Leung
2   Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
,
Wai Wang Chau
3   Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Sha Tin, Hong Kong
,
Pak Cheong Ho
3   Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Sha Tin, Hong Kong
› Author Affiliations

Abstract

Background Distal radius fracture is one of the most common injuries. Poor functional result with restricted wrist motion can be developed when there is intra-articular fibrous tissue development arising from articular step-off and gapping.

Objectives The aim of this study is to compare the functional and radiological outcome between arthroscopic-assisted reduction and fluoroscopic reduction in treating unstable intra-articular distal radius fracture.

Methods We retrospectively analyzed 12 patients with intraarticular AO type C distal radius fracture treated with arthroscopic-assisted fracture reduction and internal fixation and compared them with another group of 12 patients in which fracture reduction is assessed by fluoroscopy alone (15 males and 9 females, mean age 57.3, range 27–73). The two cohorts were analyzed for differences in radiological parameters including articular stepping and gapping, palmar tilt, radial inclination, ulnar variance as well as functional outcome in range of motion, grip strength, modified mayo wrist score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score at an average of 12.5 months (range 5–26) after surgery.

Results Arthroscopic-assisted fracture reduction group has statistically better restoration of articular stepping and gapping, volar tilt and ulnar variance. Range of motion, grip strength, modified mayo wrist score and Quick DASH score also had statistically significant improvement in arthroscopic group.

Conclusion Our study showed arthroscopic-assisted technique can precisely restore radiological parameters in highly comminuted distal radius fracture with good functional outcome. Also, associated intra-articular soft tissue injury can be detected and treated simultaneously.

Level of Evidence This is a level III, retrospective cohort study.

Ethical Approval

This research project is approved and registered under Joint CUHK-NTEC Clinical Research Ethics Committee, with the reference number of CREC 2020.182.


Authors' Contributions

The patients were recruited and treated in Alice Ho Miu Ling Nethersole Hospital. S.C.J.J.K. researched literature conceived the study, led to protocol development, gaining ethical approval, and manuscript writing. S.C.J.J.K. and K.Y.A.L. conducted patient assessment. W.W.C. performed data analysis. All authors reviewed and edited the manuscript and approved the final version of the manuscript.




Publication History

Received: 23 July 2020

Accepted: 24 August 2020

Article published online:
04 November 2020

© 2020. Thieme. All rights reserved.

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