Arthroscopic Assisted Reduction of Intra-Articular Distal Radius Fracture

Description

In this presentation led by Dr. Eric Wagner from Emory University, an in-depth discussion unfolds on the techniques and considerations surrounding arthroscopic-assisted distal radius fracture fixation. The video begins with Dr. Wagner thanking his collaborators and providing essential disclosures, including the absence of commercial support and patient consent.



The focus shifts to the indicated use of arthroscopic techniques in intraarticular fractures, particularly emphasizing cases with significant joint surface involvement while outlining contraindications such as open fractures and severe osteoporosis. A clinical vignette is introduced about a 54-year-old patient who suffered a comminuted articular distal radius fracture due to a slip and fall, which was confirmed through radiographs showing dorsal angulation and joint surface involvement.



The presentation details the surgical approach, likening it to the familiar volar plate fixation technique. Utilization of specific arthroscopic portals is described, emphasizing their strategic placements to enhance visibility of the fracture reduction process. The video highlights the advantages of dry arthroscopy in avoiding joint distension, while also acknowledging challenges like managing hemarthrosis compared to wet arthroscopy.



The practical steps involved in reducing the fracture and stabilizing it with K-wires are delineated, along with the vital role of imaging to monitor the restoration of the dorsal tilt. After achieving a satisfactory fracture reduction, further fixation with screws is performed, ensuring thorough verification through both visual inspection and arthroscopic assessment.



Concluding insights reflect on the patient’s positive recovery trajectory and the importance of effective intraarticular alignment to mitigate long-term complications like arthritis. The presentation advocates for ongoing research to explore the long-term benefits of arthroscopic assistance in fracture management, particularly highlighting its potential role in reducing the incidence of arthritis post-fracture.

Specialties