Arthroscopically Assisted Fixation of Intraarticular Distal Radial Fractures

Won-Young Lee, Byung Mun Park, Dae Eu Lim, Kyung-Sub Song, Jung Woo Hong
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Abstract

Purpose: To investigate the results of arthroscopically assisted reduction of intraarticular fracture of distal radius with percutaneous K-wires and external fixation. Materials and Methods: We reviewed 12 intraarticular distal radial fractures of 11 patients treated arthroscopically assisted reduction in Orthopedic Department of Sung-Ae hospital between January, 2001 and August, 2001. The mean length of follow-up was 14 months. Analysis of them revealed that B3 was 1 case, C2 4 cases and C3 7 cases according to the AO classification. All cases were treated by 2.7 mm arthrosopic devices and percutaneous K-wires pinning with external fixation, but additionally invasive reductional technique was not used. We removed the osteochondral flap in the joint space and detected the carpal ligaments and triangular fibrocartilage complex tears but not treated. The K-wires were removed at 4 weeks, external fixation was 7 weeks, respectively. Results: The mean active range of movement in the affected wrist was total arc of the flexion-extension 72% of the opposite side. Radiographically mean volar tilt, radial inclination and radial length were 5.7 ° , 22.4 ° , and 12.3 mm. The mean articualar step-off was 2 mm or less. Post-operative compartment syndrome and fracture collapse were not occured during follow-up period. According to the Gartland and Werley demerit-point system, eleven cases were a excellent or good and one was a fair result. Conclusion: Arthroscopically assisted fixation is a useful method for reducing the soft tissue injuries and preventing the articular surface incongruency by anatomically reduction in cases of intraarticular comminution.
关节镜辅助桡骨远端关节内骨折的固定
目的:探讨关节镜下经皮克氏针联合外固定治疗桡骨远端关节内骨折的疗效。材料与方法:回顾2001年1月至2001年8月在圣爱医院骨科接受关节镜辅助复位治疗的11例桡骨远端关节内骨折12例。平均随访时间为14个月。根据AO分类,B3为1例,C2为4例,C3为7例。所有病例均采用2.7 mm关节固定器和经皮克氏针外固定钉治疗,但未采用有创复位技术。我们切除了关节间隙的骨软骨瓣,发现了腕韧带和三角纤维软骨复合体撕裂,但没有治疗。4周取出k针,7周取出外固定。结果:患腕关节的平均活动范围为对侧屈伸总弧度的72%。x线平均掌侧倾角、径向倾角和径向长度分别为5.7°、22.4°和12.3 mm。平均间隙小于等于2毫米。随访期间未发生术后腔室综合征和骨折塌陷。根据Gartland和Werley的记分系统,11个案例是优秀或良好,1个是公平的结果。结论:关节镜下辅助固定是减少软组织损伤和防止关节面不一致的一种有效方法。
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