Wrist arthroscopy in the management of articular distal radius fractures. 2016

Francesco Smeraglia, and Angelo Del Buono, and Nicola Maffulli
Department of Orthopaedic Surgery, University of Naples Federico II, via Sergio Pansini 5, 80131 Naples, Italy.

Fractures of the distal radius account for 15% of all fractures. The use of arthroscopy is increasingly popular in the last years, with the goal to achieve a better anatomical reduction of the articular fragments. We searched the literature on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'wrist', 'distal radial fracture', 'distal radius fracture' and 'arthroscopy'. Twenty-eight studies were identified. The quality of the studies was assessed using the Coleman Methodological Score. Arthroscopy allows to detect intra-articular, ligamentous and triangular fibrocartilage complex injuries in an acute setting with a better prognosis. Arthroscopy increases the quality of the intra-articular reduction compared to fluoroscopy. The main limitation of the selected studies is the short follow-up: the average follow-up in 20 studies was 12 months, a period long enough to assess functional outcomes, but not to assess the occurrence of post-traumatic degenerative changes and their impact on function. Better stratification of the fracture population is needed. The shorter recovery time and the low incidence of adverse effects are the main advantages of this new technology. There is need to perform randomized controlled trials reporting on the use of volar locking plates as, at the present time, they are the standard management for these fractures. In addition, the different pattern of fracture should be better classified to manage the patients who will benefit after the management.

UI MeSH Term Description Entries
D008023 Ligaments, Articular Fibrous cords of CONNECTIVE TISSUE that attach bones to each other and hold together the many types of joints in the body. Articular ligaments are strong, elastic, and allow movement in only specific directions, depending on the individual joint. Articular Ligament,Articular Ligaments,Ligament, Articular
D011885 Radius Fractures Fractures of the RADIUS. Galeazzi Fracture,Galeazzi Fracture Dislocation,Radial Fractures,Dislocation, Galeazzi Fracture,Fracture Dislocation, Galeazzi,Fracture, Galeazzi,Fracture, Radial,Fracture, Radius,Radial Fracture,Radius Fracture
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001182 Arthroscopy Endoscopic examination, therapy and surgery of the joint. Arthroscopic Surgical Procedures,Surgical Procedures, Arthroscopic,Arthroscopic Surgery,Surgery, Arthroscopic,Arthroscopic Surgeries,Arthroscopic Surgical Procedure,Arthroscopies,Procedure, Arthroscopic Surgical,Procedures, Arthroscopic Surgical,Surgeries, Arthroscopic,Surgical Procedure, Arthroscopic
D014954 Wrist Injuries Injuries to the wrist or the wrist joint. Injuries, Wrist,Injury, Wrist,Wrist Injury
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017102 Fracture Healing The physiological restoration of bone tissue and function after a fracture. It includes BONY CALLUS formation and normal replacement of bone tissue. Fracture Healings,Healing, Fracture,Healings, Fracture
D057072 Intra-Articular Fractures Fractures of the articular surface of a bone. Intraarticular Fractures,Fracture, Intra-Articular,Fracture, Intraarticular,Fractures, Intra-Articular,Fractures, Intraarticular,Intra Articular Fractures,Intra-Articular Fracture,Intraarticular Fracture

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