[Wrist arthroscopy assisted reduction and Herbert screw fixation for the treatment of type B distal radius fractures].

OBJECTIVE

To explore the clinical efficacy of internal fixation with arthroscope assistance in type B fractures of distal radius.

METHODS

From June 2013 to July 2015, 28 cases of type B distal radius fracture patients were enrolled into the study, including 15 males and 13 females with an average age of 45.3 years old ranging from 17 to 69 years old. These patients were treated with manipulative and poking reduction wrist arthroscopy, internal fixation with Herbert screws and repair of articular soft tissue, and the course of disease was 4 to 7 days after injury. Injured patients had the typical signs of distal radius fracture with confirming of X ray and CT imaging. Finally, no other fractures, no neurovascular injury, no other severe diseases and no surgical cortraindications were identified. According to the classification of AO/OTA, there were 8 cases of type B1, 7 cases of type B2, 13 cases of type B3. Patients were followed up for fracture healing, wrist joint function recovery, and curative effect.

RESULTS

The 28 cases of type B distal radius fractures were followed up with an average of(12.1±1.4) months, all fractures were healed, palmer tilt angle was(15.2±3.4)°, ulnar drift angles was(20.4±6.4)°. Wrist functions were evaluated according to Cooney system and rated as excellent in 21 cases, good in 5 cases and fair in 2 cases. Intraoperative arthroscopy showed the tear of scapholunate ligaments in 3 cases, tear of in lunotriguetal ligaments in 1 case, and TFCC tear in 16 cases.

CONCLUSIONS

Wrist arthroscopy assisted treatment of distal radius fracture type B can make the recovery of joint surface roughness to a great extent. The application of Herbert screw brings in the small trauma, and the postoperative recovery time is short, reducing the incidence of traumatic arthritis and preventing the chronic pain or inastbility of the wrist in the future.