Blanco BP, Hernández CV, Ciénega RMA, González PCE

Language: English
References: 25
Page: 23-28
PDF size: 81.58 Kb.

ABSTRACT

Introduction. With a distal radius fracture, the proper bone anatomy structure restoring is essential to minimize complications. However, there are aggregate injuries which, sometimes are not recognized or diagnosed. Therefore, they are not treated and make the wrist a dysfunctional joint. The purpose of our study is to make an arthroscopic diagnosis of intra-articular injuries associated to distal radius fractures and treated with surgery and rehabilitation therapy presenting as a pain sequel and functional limitation. We also wanted to check whether the baseline fracture X-rays show information suggesting associated injuries. Material and methods. We conducted an observation, prospective, cross section,descriptive open ended study between January and December 2003. We performed 20 wrists arthroscopies on 20 patients who had suffered distal radius fracture and had been treated by closed or open reduction and fracture fixation with pins, external fixation, T plate or a combination of these with or without bone graft. Time lapsed between the fracture and the arthroscopy was an average of 5 months. With the arthroscopic procedure a triangular fibrocartilage complex (TFC) injury was intentionally searched. These injuries were classified according to Palmer. Other injuries searched were Outerbridge type chondral injuries and complete or partial injuries of interosseal ligaments. Results. Results show that all patients (100%) suffered some associated injury. In all cases we saw intra-articular bridle formation and certain degree of fibrosis. Chondral injury was seen in 85% of patients and it was the most common on the articular surface of the radius (60%). In 12 (60%) patients, we found an injured FC mostly on the cubital insertion. The interosseal ligament injury was seen in 25% of patients. Conclusions. In all cases, radius distal fracture was accompanied by associated injuries with chondral injuries being the most frequent followed by TFC injuries and interosseal ligament injuries ranking third. We found a direct relationship between the fracture class and the type of associated injury and less interosseal ligament injuries, contrary to what we saw in extra-articular fractures. TFC injuries were also more common in joint fractures. Baseline X-rays were predictive of associated injuries.

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