Arthroscopy added to ORIF for distal radius fractures may not improve function

BOSTON — Patients with displaced intra-articular distal radius fractures who underwent arthroscopy in addition to open reduction and internal fixation did not experience better function compared with open reduction and internal fixation alone, according to results presented here.

Caroline A. Selles, MD, and colleagues randomly assigned 50 patients with displaced intra-articular distal radius fractures with an inacceptable closed reduction that required operative treatment to undergo open reduction and internal fixation (ORIF) alone (n=25) or with additional arthroscopy (n=25).

“We only performed arthroscopy in 22 of these patients because in three of the patients, the dorsal capsule was also opened and no additional arthroscopy was performed,” Selles said in her presentation at the American Society for Surgery of the Hand Annual Meeting.

Selles noted all patients who underwent arthroscopy had a hematoma, which was removed, and all patients had an associated injury, most of which were a triangular fibrocartilage complex injury.

At 3 weeks, Selles said the primary outcome measure of patient-related wrist evaluation score was 58 vs. 48 in the ORIF alone and with arthroscopy groups, respectively. She added that although these scores improved at 6 weeks, there was no difference between the groups.

“At 3 months, the arthroscopy group have a [patient-related wrist evaluation] PRWE of 29 vs. 13 in the no arthroscopy group, which was significantly worse, actually, at this time point,” Selles said. “When we look at the 6-month follow-up, we see that both groups actually have returned to an acceptable PRWE score of 10.” – by Casey Tingle

Reference:

Selles CA, et al. Paper 53. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 13-15, 2018; Boston.

Disclosure: Selles reports no relevant financial disclosures.