Analysis of the Arthroscopically Diagnosed Soft-Tissue Injuries Associated With the Distal Radius Fractures
Keywords:Distal radius fractures, Wrist arthroscopy, Triangular fibrocartilage complex, soft-tissue lesions, Scapholunate ligament.
AIM: The aim of this study was to analyze the frequencies of these soft-tissue injuries and to describe the arthroscopic technique used for their diagnosis.
METHODS: The prospective study included 85 patients with operatively treated distal radius fracture. Wrist arthroscopy was used to identify the associated lesions of triangular fibrocartilage complex (TFCC), scapholunate ligament (SL) and lunitriquetral ligament (LT), extrinsic ligaments, and chondral lesions.
RESULTS: Wrist arthroscopy identified TFCC injury in 72.9%, SL injury in 65.9%, LT injury in 17.7%, extrinsic ligaments in 49.4% and chondral lesion in 30.6% of the patients. 87.1% of the patients had at least one of the major structures injured (TFCC, SL or LT). The presence of the ulnar styloid fractures significantlly correlated with with the associated LT lesion, with the LT lesion type, and with the lesion of both SL and LT ligament. If the distal radius fracture was intraarticular there was no correlation with the finding of any associated soft-tissue lesion.CONCLUSIONS: The frequency of the associated soft-tissue lesions in distal radius fractures is high. Ulnar styloid fracture was identified as risk factor for associated LT lesion, as well as combined lesion of both scapholunate and luntriquetral ligament.
Plum Analytics Artifact Widget Block
Geissler WB, Freeland AE, Savoi FH, et al. Intracarpal soft-tissue lesions associated with an intraarticular fracture of the distal end of the radius. J Bone Joint Surg Am. 1996;78:357â€“365.
Fernandez DL. Should anatomic reduction be pursued in distal radial fractures? J Hand Surg [Br]. 2000;25: 523-527.
Smith DW, Henry MH. Comprehensive management of soft-tissue injuries associated with distal radius fractures. Journal of the American Society for Surgery of the Hand. 2002;2:153-164.
Shin AY, Deitch MA, Sachar K, Boyer MI. Ulnar-sided wrist pain. J Bone Joint Surg Am. 2004; 86: 1560-1574.
Lozano-Calderon SA, Souer S, Mudgal C, Jupiter JB, Ring D. Wrist mobilization following volar plate fixation of fractures of the distal part of the radius. J Bone Joint Surg Am. 2008;90:1297-1304.
Weiss AP, Akelman E, Lambiase R. Comparison of findings of triple-injection cinearthrography of the wrist with those of arthroscopy. J Bone Joint Surg Am. 1996; 78:348-356.
Dao KD, Solomon DJ, Shin AY, Puckett ML. The efficacy of ultrasound in the evaluation of dynamic scapholunate ligamentous instability. J Bone Joint Surg Am. 2004;86:1473-1478.
Forward DP, Lindau TR, Melson DS. Intercarpal ligament injuries associated with fractures of the distal part of the radius. J Bone Joint Surg Am. 2007;89:2334â€“2340.
Lindau T, Arner M, Hagberg L. Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg [Br]. 1997;22:638â€“643.
Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg [Am]. 2000;25:464â€“468.
Richards RS, Bennett JD, Roth JH, Milne K. Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg [Am]. 1997;22:772â€“776.
Poole KE, Compston JE. Osteoporosis and its management, BMJ. 2006; 333:1251-1256.
Lichtman DM, Bindra RR, Boyer MI et as. American academy of orthopaedic surgeons clinical practice guideline on the treatment of distal radius fracture. J Bone Joint Surg Am. 2011;93:775-778.
DelPinal F, Mathoulin C, Luchetti R. Arthroscopic management of distal radius ractures. Berlin Heidelberg: Springer Verlag; 2010.
Geissler WB. Wrist arthroscopy. New York: Springer Science Business Media; 2005.
Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg [Am].1989;14:594â€“606.
, Geissler WB. Intra-articular distal radius fractures: the role of arthroscopy? Hand Clin. 2005;21:407â€“416.
Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br. 1961;43:752â€“757.
Muller ME, Nazarian S, Koch P, et al. The Comprehensive Classification of Fractures of Long Bones. Berlin Heidelberg New York: Springer-Verlag; 1991.
Larsen CF, Lauritsen J. Epidemiology of acute wrist trauma. Int J Epidemiol. 1993;22:911-916.
Walenkamp MMJ, Bentohami A, Beerekamp MSH, Peters RW, van der Heiden R, Goslings JC, Schep NWL. Functional outcome in patients with unstable distal radius fractures, volar locking plate versus external fixation: a meta-analysis. Strat Traum Limb Recon. 2013;8:67-75.
Kasapinova K, Kamiloski V. Open reduction and internal fixation versus external fixation and/or Kirschner wires for distal radius fractures. A systematic review. Contributions. Sec. Med. Sci. 2014;35(1):225-236.
Hull P, Baraza N, Gohil M, Whalley H, Mauffrey C, Brewster M, Costa ML. Volar locked plates versus K-wire fixation of dorsally displaced distal radius fractures - a functional outcome study. J Trauma. 2011;70:E125-E128.
Wilcke MK, Abbaszadegan H, Adolphson PY. Wrist function recovers more rapidly after volar locked plating than after external fixation but the outcomes are similar after 1 year. Acta Orthop. 2011;82:76-81.
Mehta JA, Bain GI, Heptinstall RJ. Anatomical reduction of intra-articular fractures of the distal radius (an arthroscopically-assisted approach). J Bone Joint Surg Br. 2000;82:79â€“86.
Hanker GJ. Radius fractures in the athlete. Clin Sports Med. 2001;20:189â€“201.
Ogawa T, Tanaka T, Yanai T, Kumagai H, Ockiai N. Analysis of soft tissue injuries associated with distal radius fractures. BMC Sports Science, Medicine and Rehabilitation. 2013;5:19.
Lindau T. Treatment of injuries to the ulnar side of the wrist occurring with distal radial fractures. Hand Clin. 2005;21:417â€“425.
Knirk JL, Jupiter JB. Intraarticular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68:647-659.
Whipple TL. The role of arthroscopy in the treatment of scapholunate instability. Hand Clin. 1995;11:37-40.
Peicha G, Seibert F, Fellinger M, et al. Midterm results of arthroscopic treatment of scapholunate ligament lesions associated with intra-articular distal radius fractures. Knee Surg Sports Traumatol Arthrosc. 1999;7:327â€“333.
How to Cite
All rights reserved.