Traitement des fractures articulaires du radius distal sous arthroscopie : le but anatomique est-il atteint ?

Contribution of arthroscopy to the management of intra-articular distal radius fractures: Knowledge update based on a systematic 10-year literature review

The objective of this study was to review current data on the contribution of wrist arthroscopy to the management of intra-articular distal radius fractures (IADRFs). The literature published over the last 10 years was reviewed by searching databases with the key indexing terms 'distal radius fracture', 'articular', and 'wrist arthroscopy'. The information in the 21 articles thus retrieved was used to answer the following questions: (i) Can arthroscopy improve the reduction of IADRFs? (ii) How does arthroscopy contribute to the diagnosis and treatment of concomitant ligament injuries? and (iii) Does arthroscopy help to improve the functional scores? The contribution of arthroscopy to IADRF reduction remains controversial. Follow-ups were limited (15 months on average) and some of the studies provided only level IV evidence. The data do not consistently suggest that arthroscopically assisted surgery may improve the quality of reduction. In contrast, they highlight the usefulness of arthroscopy in allowing the same-stage management of carpal ligament injuries. In the 12 studies providing data on this point, scapholunate inter-osseous ligament injuries were present in 41% of cases; one-fourth of these injuries were full-thickness tears that were successfully repaired by arthroscopy. The triangular fibrocartilage complex was injured in 48% of cases, and 30% of these injuries were peripheral ulnar detachments that were successfully repaired by arthroscopy. At present, arthroscopy does not allow the repair of all diagnosed ligament injuries. Comparative studies with longer follow-ups will shed light on the ability of arthroscopy to improve functional scores. LEVEL OF EVIDENCE: IV.