Interosseous ligaments and TFCC lesions in intraarticular distal radius fractures - radiographic versus arthroscopic...

Background. Intraarticular distal radius fractures are marked by a significant amount of soft tissue damage, which is not always noticed on routine X-rays. The lack of early diagnosis and treatment of these lesions can lead to the development of carpal instability, and subsequently to limited range of motion or wrist pain syndrome. The purpose of this article is to show how these lesions can be diagnosed arthroscopically, and at the same time to compare arthroscopic evaluation to standard X-rays. Material and methods. In the period from August 2004 to April 2005 we performed 21 wrist arthroscopies in 20 patients with intraarticular distal radius fractures (7 women and 13 men, ranging in age from 20 to 63 years, average age 38). Results. In all these patients, numerous soft tissue lesions were found during arthroscopic examination: TFCC lesions in 13 patients, SL ligament lesions in 7 patients, and an LT ligament lesion in 1 case. None of these lesions were visible in X-rays. An ulnar styloid fracture was found in 9 cases, in 4 cases associated with TFCC lesions. Loose bodies, not seen in previous X-rays, were detected in 8 patients. Conclusions. Arthroscopy in intraarticular distal radius fractures facilitates the diagnosis and treatment of soft tissue lesions, which are numerous and usually not detected on standard X-rays.