Learning curve of arthroscopic-assisted distal radius fracture with volar plating

Arthroscopic-assisted surgery for distal radius fracture is widely performed, while is a technically demanding procedure. The purpose of this study was to quantify the learning curve of arthroscopic-assisted surgery by analyzing the operative time.

Fifty-three cases with distal radius fracture (intra-articular fractures only) treated by arthroscopic-assisted procedure with volar plating (mean age 63 years old, range 16 to 92 years old, 17 males, 36 females) by a single surgeon was included in this study. First, the fracture was reduced. Then, arthroscopic procedure was performed to check the articular surface. If the articular step-off deformity (>2mm) remained, additional reduction was performed and fixed with a volar plate. The learning curve of the time required for the operation was analyzed.

Consecutive blocks were analyzed. The mean time and the standard deviation in the first half were 91+14 minutes (71-125 min.), and 77+10 minutes (42-112 min.) in the second half. The time decreased significantly in the second half than in the first half. This was comparable to the previous report that the learning curve was steep.

We consider the accumulation of surgical cases and active participation in cadaver training may help to shorten the learning curve.

Keywords: Arthroscopic-assisted surgery, distal radius fracture, learning curve