Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 14, Issue 11, pp 1225–1230 | Cite as

Wrist arthroscopy and intra-articular fractures of the distal radius in young adults

  • Philippe HardyEmail author
  • Nuno Gomes
  • Mounir Chebil
  • Thomas Bauer


The difficulty on treatment of articular fractures of the distal radius comes from their comminutive character and frequency of ligamentous lesions associated, turning diagnosis and assessment always subject to discussion. Fracture reduction and fixation under arthroscopic control, along with ligamentous injury treatment, provides the Surgeon with a valuable tool in order to achieve best results on follow-up. Eighteen fractures of the distal radius on 18 young adults (average age of 28.6 years), all intra-articular and 9 with ligamentous lesions associated, were operated on under arthroscopic control. Results from an average distance of 12.2 months were appraised following the score of Green and O’Brien modified by Cooney. They were excellent in five cases, good in eight cases, average in four cases and bad in one case. Recovery was best for fractures with weak comminution and when articular congruence was restored. Arthroscopy, allowing control of fracture reduction, to diagnose and possibly treat associated ligamentous lesions, constitutes a good alternative to open surgical treatment. Level of evidence: case series (level IV).


Wrist Arthroscopy Radius Fracture 


  1. 1.
    Abboudi J, Culp RW (2001) Treating fractures of the distal radius with arthroscopic assistance. Orthop Clin North Am 30(2):307–315CrossRefGoogle Scholar
  2. 2.
    Auge WK, Velazquez PA (2000) The application of indirect reduction techniques in the distal radius: the role of adjuvant arthroscopy. Arthroscopy 16(8):830–835PubMedCrossRefGoogle Scholar
  3. 3.
    Basset RL (1987) Displaced intra articular fractures of the distal radius. Clin Orthop 214:148–152Google Scholar
  4. 4.
    Bohringer G, Schadel-Hopfner M, Petermann J, Gotzen L (2002) A method for all-inside arthroscopic repair of Palmer 1B triangular fibrocartilage complex tears. Arthroscopy 18(2):211–213PubMedCrossRefGoogle Scholar
  5. 5.
    Bradway JK, Amadio PC, Cooney WP (1989) Open reduction and internal fixation of displaced comminuted intra articular fractures of the radius. J Bone Joint Surg 71A:839–847Google Scholar
  6. 6.
    Chen AC, Chan YS, Yuan LJ, Ye WL, Lee MS, Chao EK (2002) Arthroscopically assisted osteosynthesis of complex intra-articular fractures of the distal radius. J Trauma Aug 53(2):354–359CrossRefGoogle Scholar
  7. 7.
    Cooney WP, Bussey R, Dobyns JH, Linscheid RL (1987) Difficult wrist fractures and perilunate fracture dislocations of the wrist. Clin Orthop 214:136–147PubMedGoogle Scholar
  8. 8.
    Edwards CC, Haraszti CJ, McGillivary GR, Gutow AP (2001) Intra-articular distal radius fractures: arthroscopic assessment of radiographically assisted reduction. J Hand Surg [Am] 26(6):1036–1041CrossRefGoogle Scholar
  9. 9.
    Freeland AE, Geissler WB (2000) The arthroscopic management of intra-articular distal radius fractures. Hand Surg 5(2):93–102PubMedCrossRefGoogle Scholar
  10. 10.
    Geissler WB (1998) Arthroscopic assisted reduction of intra articular radius fractures. Sports Med Arthrosc Rev 6:278–286Google Scholar
  11. 11.
    Goldfarb CA (2004) Case controversy: distal radius. Opinion: arthroscopically assisted fracture fixation. J Orthop Trauma 18(4):251–252PubMedCrossRefGoogle Scholar
  12. 12.
    Hanker GJ (1987) Diagnostic and operative arthroscopy of the wrist. Clin Orthop 241:136–147Google Scholar
  13. 13.
    Hixon ML, Walker CW, Fitzrandolf RL, Andrew CW (1990) Acute ligament tear of the wrist associated with Colle’s fracture. Orthop Trans 14:164–165Google Scholar
  14. 14.
    Jupiter JB, Lipton H (1993) The operative treatment of intra articular fractures of the distal radius. Clin Orthop 292:48–61PubMedGoogle Scholar
  15. 15.
    Kapandji A (1976) L’embrochage intra focal des fractures de l’extrémité inférieure du radius. Ann Chir 30:903–908PubMedGoogle Scholar
  16. 16.
    Knirk JL, Jupiter JB (1986) Intra articular fractures of the distal end of the radius in young adults. J Bone Joint Surg 68A:647–659Google Scholar
  17. 17.
    Levy, Howard J, Glickel (1993) Arthroscopic assisted internal fixation of volar intra-articular fractures of the wrist. Arthroscopy 9:122–124PubMedCrossRefGoogle Scholar
  18. 18.
    Mayfield JK (1984) Patterns of injury to carpal ligaments. Clin Orthop 187:36–42PubMedGoogle Scholar
  19. 19.
    Mohanti RC, Kar N (1979) Study of triangular fibrocartilage of the wrist joint Colle’s fractures. Injury 2:321–326Google Scholar
  20. 20.
    Palmer AK (1990) Triangular fibrocartilage disorders: injury paterns and treatment. Arthroscopy 6:125–132PubMedCrossRefGoogle Scholar
  21. 21.
    Pattee GA, Thompson GH (1988) Anterior and posterior marginal fracture-dislocations of the distal radius. Clin Orthop 231:183–195PubMedGoogle Scholar
  22. 22.
    Rongiere M, Laques D, Roques B, Mansat M (1998) Fractures de l’extrémité distale du radius et lésions ligamentaires intracarpiennes. Fractures du radius distal de l’adulte. Conférence d’Enseignement. In: Cahier d’enseignement de la SOFCOT Paris. Expansion Scientifique Française 67:218–224Google Scholar
  23. 23.
    Ruch DS, Yang CC, Smith BP (2003) Results of acute arthroscopically repaired triangular fibrocartilage complex injuries associated with intra-articular distal radius fractures. Arthroscopy 19(5):511–516PubMedCrossRefGoogle Scholar
  24. 24.
    Ruch DS, Vallee J, Poehling GG, Smith BP, Kuzma GR (2004) Arthroscopic reduction versus fluoroscopic reduction in the management of intra-articular distal radius fractures. Arthroscopy 20(3):225–230PubMedCrossRefGoogle Scholar
  25. 25.
    Scheck M (1962) Long term follow up of treatment of comminuted fractures of the distal end of the radius by transfixion with Kirschner wires and cast. J Bone Joint Surg Am 44A:337–351Google Scholar
  26. 26.
    Trumble TE (1998) Intra-articular fractures of the distal radius. J Bone Joint Surg 80A:582–900Google Scholar
  27. 27.
    Trumble TE, Schmitt SR, Vedder NB (1994) Factors affecting functional outcome of displaced intra-articular distal radius fractures. J Hand Surg 19A:325–340Google Scholar
  28. 28.
    Whipple TL (1992) Arthroscopic surgery. The wrist. Philadelphia, LipincottGoogle Scholar
  29. 29.
    Whipple T (1995) The role of arthroscopy in the treatment of intra-articular wrist fractures. Hand Clin 11:13–18PubMedGoogle Scholar
  30. 30.
    Wolfe S, Kenneth J Easterling, Yoo Ho H (1995) Arthroscopic assisted reduction of the distal radius fractures. Arthroscopy 11(6):706–714PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Philippe Hardy
    • 1
    Email author
  • Nuno Gomes
    • 1
  • Mounir Chebil
    • 1
  • Thomas Bauer
    • 1
  1. 1.Service Orthopédie et TraumatologieHôpital Ambroise Paré, CHU Paris Ile de France OuestBoulogneFrance

Personalised recommendations