Article

Our study aimed to compare the anatomical result after treatment of
intraarticular distal radius fracture with locking volar plates with and without
arthroscopy. This was a retrospective, single-center study of intraarticular
fractures. A volar locked plate was used for fracture fixation in all patients.
Twenty patients were operated on with fluoroscopy only
("plate" group) and 20
operated using arthroscopy assistance ("arthroscopy" group). All patients
underwent a CT scan before surgery and at 3 months postoperative. The main
outcome measure was the residual intraarticular step-off (measured in
millimeters). Other studied outcomes were the residual gap between fragments and
extra-articular reduction. The two groups were similar preoperatively in all
aspects except the size of the gap between fragments. The residual step-off was
significantly less in the arthroscopy group: 1.9mm (Q1 1.7; Q3 2.25) for plate
versus 0.8mm (Q1 0.7; Q3 1.5) for arthroscopy (P=0.001). The change from the
preoperative to the postoperative measurement was significantly greater in the
arthroscopy group: 0.1 mm (Q1 -0.5; Q3 0.8) for plate and -1mm (Q1 -1.9; Q3 -0.6)
for arthroscopy (P=0.0002). The residual gap was similar between both groups:
2.4mm (Q1 1.9; Q3 3.5) for plate vs. 2.3mm (Q1 1.1; Q3 2.8) for arthroscopy
(P=0.37). The change in gap was not significantly different between the two
groups: -0.9mm (Q1 -1.8; Q3 -0.1) for plate vs. -2.9mm (Q1 -4.4; Q3 -1.7) for
arthroscopy (P=0.32). There was no difference in the extra-articular reduction.
Damage was found to the scapholunate ligament in 30% and the TFCC in 30% of
arthroscopy cases. Arthroscopy improves intraarticular reduction without altering
extra-articular reduction in patients with intraarticular fractures of the distal
radius, and it allows for assessment and treatment of any injuries discovered. We
must now follow these patients over the long-term to assess the clinical benefit.
LEVEL OF EVIDENCE: 3.
CI - Copyright (c) 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS