Treatment Of Comminuted Distal Radius Fracture With Carpal Arthroscope-assisted Volar LCP Internal Fixation

Objective:To investigate the clinical efficacy of carpal arthroscope-assisted volar LCP internal fixation and two other methods in the treatment of AO C-type distal radius fractures.Methods:From February 2015 to November 2017,68 patients with AO/ASIF C type distal radius fractures were treated with three different methods.They were in the Second Affiliated Hospital of Suzhou University and Zhangjiagang Hospital of Suzhou University.Among them,14 cases were treated with external fixator combined with Kischner wire(group A).34 cases were treated with volar LCP internal fixation(group B,two of them were bilateral),20 cases were treated with carpal arthroscope-assisted volar LCP internal fixation(group C).We measured palmar inclination,ulnar deviation,radius height and articular surface flatness before and after surgery.Wrist function was assessed by Sarmiento modified Gartland&Werley wrist scoring system.Subjective pain of patients was assessed by VAS visual scale method.Results:All patients were followed up,the follow-up time is 13-48 months,an average of 16 months,obtained osseous healing of fracture,postoperative radiographic measurement data is also had an improved preoperative,postoperative recovery of limb function of wrist joint is good,no obvious complications occurred,according to the Gartland&Werley scoring criteria,group A was 78.5%,B group was 82.3%,group C was 85%.Compared with group A,group B and group C recovered better in postoperative palmaris inclination,radial height and articular surface steps,with statistical significance.The performance of group C was better than that of group B in articular surface step recovery,with statistical significance.Ulnar Angle recovery was not statistically significant in the three groups.There was no statistical significance between the postoperative VAS pain score and Gartland&Werley score in the three groups,but the excellent and good rate was better in the C group.Conclusion:The application of carpal arthroscope-assisted volar LCP internal fixation in the treatment of AO c-type distal radial fracture can make the articular surface reduction more even,and can simultaneously detect and repair the wrist ligament injury,improve the wrist joint extension and flexion and rotation,and achieve a higher excellent rate and good efficacy.