[Preliminary effectiveness of carpal arthroscopic adjuvant treatment of intra-articular fractures of distal radius].

Objective: To investigate the early-term effectiveness of carpal arthroscopy in the treatment of intra-articular fractures of distal radius.

Methods: The clinical data of 50 cases of intra-articular fractures of distal radius between January 2015 and December 2017 were retrospectively analyzed. According to the different methods of intraoperative assisted treatment, the patients were divided into the trial group (11 cases with carpal arthroscopy assisted treatment) and the control group (39 cases with traditional open reduction). There was no significant difference between the two groups in general data such as gender, age, affected side, cause of injury, time from injury to operation, and preoperative displacement ( P >0.05), which were comparable. Six patients in the trial group had triangular fibrocartilage complex (TFCC) injury and received one-stage repair. Postoperative X-ray films were taken to estimate the fracture reduction. Patient-Rated Wrist Evaluation (PRWE) wrist function score and modified Mayo score were used at 3 months after operation to evaluate the function of the wrist. The range of wrist flexion, extension, pronation, and supination motion of the two groups were recorded and compared at 3 months after operation. Patients in the trial group were further divided into the reduction group after arthroscopic exploration (group A, 6 cases) and the simple cleaning group after arthroscopic exploration (group B, 5 cases), and their wrist motions were compared.

Results: The operation time of the trial group was greater than that of the control group ( t =11.08, P =0.00). There was no significant difference in intraoperative blood loss and fracture reduction between the two group ( P >0.05). X-ray film at 1 day after operation showed that the degree of fracture displacement was significantly decreased when compared with preoperative one in each group ( P <0.05), but no significant difference was found between the two groups at 1 day after operation ( t =0.19, P =0.85). Patients in both groups were followed up 8-20 months, with an average of 12 months. There was no significant difference in fracture healing time between the two groups ( t =0.52, P =0.60). At 3 months after operation, the PRWE score, modified Mayo score, and wrist motions in the trial group were all better than those in the control group ( P <0.05). There was no significant difference in wrist motions between group A and group B ( P >0.05).

Conclusion: Carpal arthroscope assisted treatment of intra-articular fractures of distal radius can achieve good reduction and postoperative function. Meanwhile, TFCC, ligament, articular cartilage, and other injuries can be repaired in one stage.