Use of arthroscopy and external fixation for radiocarpal fracture-dislocation

Fracture-dislocation of the radiocarpal joint is high-energy trauma and relatively rare. We have utilized wrist arthroscopy and external fixation for diagnosis and treatment of these cases. The aim of this study is to assess the clinical results of arthroscopy and external fixation used for fracture-dislocation of the radiocarpal joint.

A retrospective study of cases from 2006 to the present was conducted. There were 6 cases, all male, mean age 43 years, 4 right and 2 left. The causes of injury were falls from height in 3 cases, traffic accidents in 2 cases, and a fall from a standing position in 1 case. Arthroscopy and external fixation were used in all cases. Arthroscopic findings, plain radiographs, CT images, and postoperative physical findings were reviewed.

There were 5 cases of dorsal dislocation and 1 case of palmar dislocation. Dumontier’s classification was group 1 in 3 cases and group 2 in 3 cases. All patients were found to have carpal fractures or carpal ligament injuries, intra-articular cartilage injuries, and other injuries that could be confirmed arthroscopically. Although the x-rays show signs of osteoarthritis, such as a narrowing of the joint space, good wrist function was generally achieved in all patients. In four cases that underwent arthroscopic mobilization at the time of implant removal, intra-articular septal-like synovial proliferation was observed, and resection of the synovial proliferation improved range of motion.

The results suggest that wrist arthroscopy is excellent for evaluation of dislocated radiocarpal fracture-dislocation, and that good results can be obtained in combination with external fixation.

Keywords: arthroscopy, external fixation, radiocarpal, fracture-dislocation