Recommendation of second look wrist arthroscopy for distal radius fracture

Yukio Abe, MD, PhD, Youhei Takahashi, MD, PhD, Yosinori Sugita, OTR

Introduction:

We have carried out wrist arthroscopy for the surgical treatment of distal radius fracture and have achieved over 700 wrists so far. Among them, we have tried second look arthroscopy for the patients who had comminuted fracture of the joint surface, associated with soft tissue injury like TFCC foveal tear and SL ligament tear, and resulted in wrist contracture after surgery etc. A second look arthroscopy has taught us a lot. I would like to present what we have realized through second look arthroscopy for distal radius fracture.

Results:

A small gap and step-off of the joint surface were well healed with fibrous cartilage. Even if there is a large defect, it may also be well healed depending on its location of the joint surface. Fibrous tissue formation in the joint, sometimes like septum, proliferated between the chondral defect of the joint surface and interosseous ligament at the early period after surgery and might become the cause of wrist contracture. SL ligament injury and TFCC foveal tear associated with distal radius fracture were well healed with simultaneous repair with the fixation of distal radius fracture.

Discussion:

These findings of second look arthroscopy may encourage the surgeon’s knowledge and ability for treating distal radius fracture. We recommend performing second look arthroscopy as the sequence of the surgical treatment of distal radius fracture with intra-articular fracture and soft tissue injury. Wrist contracture after surgery is also indicated.