Intra-articular distal radius fractures: the role of arthroscopy?

Arthroscopic assisted fixation of distal radius fractures offers several advantages. It allows for the evaluation of the articular reduction under a bright light and magnification. Particularly, rotation of the fracture fragments, which is difficult to judge under fluoroscopy, may be detected arthroscopically and corrected. Washing out fracture hematoma and debris potentially allows for improved range of motion, as shown by the studies of Doi and Stewart. Wrist arthroscopy also allows for detection and management of associated soft tissue injuries, which has been shown to occur with distal radius fractures. Some of the more severe interosseous ligament injuries can be diagnosed on plain or traction radiographs. Arthroscopy performed at the same time as fracture reduction, however, substantially increases the recognition of these injuries. In addition, it is wellknown that the management of acute interosseous ligament tears has a better prognosis when compared with chronic lesions.