Article
Arthroscopic treatment of chronic wrist pain after distal radius fractures
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Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: The purpose of this study is to report the arthroscopic findings and clinical results of patients with chronic wrist pain after distal radius fracture who underwent diagnostic arthroscopy and arthroscopic-assisted tailored treatment.
Methods: We retrospectively analyzed the records of 11 chronic wrist pain patients after distal radius fracture, who underwent diagnostic arthroscopy and arthroscopic-assisted tailored treatment from 2010 to 2015. Average patient age was 49 years (range 31-68 years), the average time from injury to treatment was 13.8 months (range 3-36 months) and the average follow up period was 17.5 months (range 12-39 months). The functional outcome was evaluated by comparing the range of motion, grip strength, pinch strength, visual analogue scale (VAS) for pain and quick Disabilities of the Arm, Shoulder and Hand questionnaire (Quick DASH score), which were measured preoperatively and at final follow up.
Results and Conclusions: Based on the arthroscopic findings, we could find synovitis in all cases and we could classify the pathologic intra-articular lesions into 4 patterns. TFCC rupture was seen in 11 cases, intercarpal ligament rupture and radiocarpal ligament rupture was in 7 cases, ulnar impaction syndrome was observed in 4 cases, and cartilage defect was noted in 8 cases. In terms of surgical treatment, 11 patients underwent arthroscopic synovectomy, 5 underwent foveal or capsular repair of TFCC, 5 underwent intercarpal K-wires fixation or intercarpal thermal shrinkage, 1 underwent intercarpal ligament reconstruction, 2 underwent Sauve-Kapandji procedure and 1 underwent unlar shortening osteotomy. Postoperatively, the average range of motion, grip strength and pinch strength increased significantly. The average VAS score increased from 6.4 (range 4-8) preoperatively to 1.3 (range 0=3) at the final follow up (P=0.003), while the average quick DASH score decreased from 54.9 preoperatively to 14.7 at the final follow up (P=0.003).
Diagnostic arthroscopy and arthroscopic-assisted tailored treatment of chronic wrist pain after distal radius fracture can provide an accurate diagnosis, significant pain relief and functional improvement.