Our Summary

This research paper explores the effectiveness of a certain treatment for a specific type of wrist fracture (Fernandez type IV fractures of the distal radius). The treatment involves wrist arthroscopy (a procedure that uses a small camera to look inside a joint), open reduction (a surgery to realign the bones), and reconstruction of a ligament in the wrist through osseous internal fixation (the use of metal implants to stabilize the bones).

The study was conducted on 11 patients (eight males and three females aged between 23 and 42) from January 2018 to December 2019. After the treatment, the researchers monitored the patients for a year to a year and a half to see how well their fractures healed, how active their wrist joints were, and how well their wrist function recovered. They used a pain scale (VAS) to assess the patients’ pain levels 12 months after the surgery and another scale (Cooney wrist score) to evaluate the overall results of the treatment.

The findings revealed that all patients’ fractures healed well within 4 to 6 months following the treatment. Their pain levels ranged from none to moderate a year after the surgery. The angle and motion range of their wrists and forearms, as well as their overall wrist function scores, varied but were generally good. Eight patients had excellent outcomes, two had good outcomes, and one had a fair outcome. None of the patients developed arthritis or complications as a result of the treatment.

In conclusion, the study suggests that this particular treatment for Fernandez IV distal radius fractures can effectively stabilize the fracture and lead to satisfactory outcomes when followed by appropriate physical therapy.

FAQs

  1. What is the clinical effect of treatment for distal radius Fernandez type IV fractures by wrist arthroscopy assisted open reduction and volar ligament reconstruction?
  2. How does the Cooney wrist score scale evaluate the clinical effects of the wrist arthroscopy assisted open reduction and volar ligament reconstruction?
  3. What are the postoperative results observed in patients who underwent wrist arthroscopy assisted open reduction and volar ligament reconstruction for Fernandez IV distal radius fractures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about wrist arthroscopy is to follow the postoperative rehabilitation plan closely to ensure optimal healing and recovery of wrist function. This may include physical therapy exercises, wearing a splint or brace as needed, and avoiding activities that could put excessive strain on the wrist. It is important to communicate any concerns or changes in symptoms to your healthcare provider during the recovery process.

Suitable For

Patients who are typically recommended wrist arthroscopy include those with distal radius Fernandez type Ⅳ fractures who have not responded well to conservative treatment or who have complex fractures that require surgical intervention. These patients may experience pain, limited range of motion, and instability in the wrist joint, and may benefit from the precise visualization and minimally invasive nature of arthroscopic surgery. Additionally, patients who have failed previous surgical interventions for distal radius fractures may also be recommended wrist arthroscopy for further evaluation and treatment.

Timeline

Before wrist arthroscopy:

  1. Patient experiences a distal radius Fernandez type Ⅳ fracture.
  2. Patient may have pain, swelling, and limited range of motion in the wrist.
  3. Patient undergoes imaging studies to assess the extent of the fracture.
  4. Treatment options are discussed with the patient, including wrist arthroscopy assisted open reduction and volar ligament reconstruction through osseous, internal fixation.

After wrist arthroscopy:

  1. Surgery is performed to reduce the fracture and reconstruct the volar ligament using wrist arthroscopy.
  2. Fracture healing is monitored over the following 4 to 6 months.
  3. Patient undergoes rehabilitation and physical therapy to regain wrist joint function.
  4. Follow-up evaluations are conducted at 12 to 13 months postoperatively.
  5. Pain levels are assessed using the visual analogue scale (VAS).
  6. Wrist joint function is evaluated using measures such as palm tilt angle, ulnar drift angle, range of motion, and Cooney wrist score.
  7. Most patients achieve excellent or good clinical outcomes with improved wrist function and no complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about wrist arthroscopy for treatment of distal radius Fernandez type Ⅳ fractures may include:

  1. What is wrist arthroscopy and how does it work in treating my specific type of fracture?
  2. What are the benefits and risks of wrist arthroscopy assisted open reduction and volar ligament reconstruction compared to other treatment options?
  3. What is the expected recovery time after undergoing this procedure?
  4. How soon after the surgery will I be able to resume normal activities and return to work?
  5. Are there any potential complications or side effects associated with wrist arthroscopy for this type of fracture?
  6. How successful is this procedure in achieving pain relief and improving wrist function in the long term?
  7. Will I require physical therapy or rehabilitation after the surgery, and if so, what does that involve?
  8. How frequently will I need follow-up appointments to monitor my progress and healing after the surgery?
  9. Are there any specific lifestyle changes or precautions I should take after undergoing wrist arthroscopy for this type of fracture?
  10. Can you provide me with more information about your experience and success rates in performing this procedure for distal radius Fernandez type Ⅳ fractures?

Reference

Authors: Cheng YB, Yang S. Journal: Zhongguo Gu Shang. 2022 Jun 25;35(6):566-71. doi: 10.12200/j.issn.1003-0034.2022.06.012. PMID: 35730228