Functional and Radiological Outcomes Following Arthroscopic-Assisted Reduction and Fixation of Intra-Articular Distal Radius Fractures

Abstract

Intra-articular distal radius fractures (DRFs) are prevalent injuries that are usually difficult to treat and rehabilitate. These injuries may be associated with ligamentous injuries or intra-articular loose fragments. This study aims to assess the functional and radiological results of using arthroscopic-assisted reduction and fixation, which offers direct visualization of the joint surface, evaluation of intra-articular ligaments, and removal of loose fragments, potentially enhancing recovery outcomes. This quasi-experimental interventional study evaluated the functional and radiological outcomes of arthroscopic-assisted reduction and fixation for intra-articular DRFs. The study included 26 patients who met specific inclusion criteria, and data collection involved preoperative assessment, patient preparation, operative measures, postoperative care, and follow-up evaluations using various scoring systems. The range of motion showed a significant (P < 0.001) improvement over the study duration: flexion increased from 42.81° ± 11.81° at 6 weeks to 54.23° ± 14.95° at 12 months, and extension improved from 56.88° ± 13.28° to 68.38° ± 13.43°. In addition, there was a significant reduction in disability and wrist-related symptoms, as indicated by improvements in the Disabilities of the Arm, Shoulder, and Hand (DASH) scores (6 weeks: 25.80 ± 15.85 vs. 12 months: 5.27 ± 8.61; P < 0.01) and Patient-Rated Wrist Evaluation (PRWE) scores at the same follow-up intervals (6 weeks: 46.04 ± 22.49 vs. 12 months: 9.54 ± 12.03; P < 0.001). Chronic illness and injuries like triangular fibrocartilage complex tears affected outcomes negatively. Age, ulnar variance, and palmar tilt were significantly correlated with DASH and PRWE scores. Arthroscopic-assisted reduction and fixation for intra-articular DRFs resulted in favorable outcomes regarding the range of motion, disability, and wrist-related symptoms. Further research and long-term follow-up studies are recommended to validate the positive outcomes of arthroscopic-assisted reduction and fixation for intra-articular DRFs, compare it with other surgical approaches, and assess its economic implications.