Clinical efficacy of traditional open reduction and internal fixation versus minimally invasive wrist arthroscopy in treatment of unstable distal radius fracture

Abstract:

Objective：To investigate the clinical efficacy of traditional open reduction and internal fixation versus minimally invasive wrist arthroscopy in the treatment of unstable distal radius fracture. Methods：Eighty-six patients with unstable distal radial fracture who underwent surgery in our hospital from January 2014 to December 2016 were enrolled in this study. They were divided into ob－servation group（n=41） and control group（n=45） according to different operation methods. The observation group underwent minimally invasive wrist arthroscopy，while the control group underwent traditional open reduction and internal fixation. The following indices were compared between the two groups：fracture healing time，the volar tilt angle，ulnar inclination angle，radial shortening，and modi－fied Sarmiento score before surgery and at 3 months after surgery，and the modified Gartland-Werley wrist function score and wrist joint range of motion at the last follow-up，as well as the incidence of complications. Results：There were no significant differences in fracture healing time and the volar tilt angle，ulnar inclination angle，radial shortening，and modified Sarmiento score before surgery and at 3 months after surgery between the two groups（P >0.05）. Compared with the control group，the observation group had significantly better wrist function and wrist joint range of motion in all directions at the last follow-up（P<0.05）；the observation group had significantly lower incidence rates of joint surface roughness and （traumatic） arthritis during the follow-up（P <0.05）. Conclusion：Minimally invasive wrist arthroscopy can achieve similar recent fracture reduction to traditional open reduction and internal fixation in the treatment of unstable distal radius fracture，but it has an ad－vantage in recovery of wrist function after fracture healing. Therefore，it holds promise for clinical application.