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The Role of Arthroscopy in Postfracture Stiffness

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Arthroscopic Management of Distal Radius Fractures

Abstract

Painful limitation of wrist range of motion (ROM) as a consequence of extraarticular and intraarticular wrist fractures is commonly seen in conservative as well as surgical management (Table 12.1) [2, 21]. Wrist rehabilitation for a period of over 3 months is the treatment of choice, when the patient has wrist stiffness. Although variable improvement is always seen in post rehabilitation, the pain persists throughout and even after the treatment, thereby making the research into the causes of such a condition mandatory [13, 22]. Frequently, incorrect or incomplete reduction of the distal radius fracture is the cause of the painful wrist function. Macroscopic defects, both intraarticular and extraarticular malunion, need to be rectified by osteotomies of distal radius [10] that try to restore normal distal radius anatomy and alignment of the articular surface of the radius. Minimal distal radius defects can be treated arthroscopically. In minimal distal radial defects, two main conditions can contribute to painful wrist ROM limitation: (1) capsular contracture with intraarticular fibrotic bands causing rigidity (the most frequent condition), and (2) incorrect healing of multiple fragment (chip) fractures of the radial dorsal border leading to a dorsal radiocarpal conflict (Figs. 12.1 and 12.2) or a moderate increase in palmar inclination of the distal radius articular surface (palmar tilt). The two conditions can sometimes coexist and must be treated at the same time.

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Authors and Affiliations

  1. Rimini Hand Surgery & Rehabilitation Center, Rimini Multimedia Policlinic, Milano, Via Pietro da Rimini 4, 47900, Rimini, Italy

    Riccardo Luchetti

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  1. Riccardo Luchetti
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Correspondence to Riccardo Luchetti .

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Editors and Affiliations

  1. Calderón de la Barca 16-entlo., Santander, 39002, Spain

    Francisco Piñal

  2. Via Pietro da Rimini 4, Rimini, 47900, Italy

    Riccardo Luchetti

  3. Institut de la Main, Clinique Jouvenet, square Jouvenet 6, Paris CX, 75007, France

    Christophe Mathoulin

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Luchetti, R. (2010). The Role of Arthroscopy in Postfracture Stiffness. In: Piñal, F., Luchetti, R., Mathoulin, C. (eds) Arthroscopic Management of Distal Radius Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-05354-2_12

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  • DOI: https://doi.org/10.1007/978-3-642-05354-2_12

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  • Online ISBN: 978-3-642-05354-2

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