Analysis of soft tissue injuries associated with distal radius fractures

Soft tissue injuries associated with distal radius fractures have been reported by some authors. Arthroscopy can be used to evaluate the condition of the articular surface and intracarpal soft tissues and as an aid to treatment. There are three intracarpal soft tissues of particular importance: the triangular fibrocartilage complex (TFCC), the scapholunate interosseous ligament (SLIL), and the lunotriquetral interosseous ligament (LTIL). The purpose of this study was to evaluate intracarpal soft tissue injuries and their relationships with fracture types during arthroscopic surgical treatment of distal radius fractures.

Eighty-nine patients in our hospital underwent surgical treatment by arthroscopy for a fracture of the distal end of the radius. They ranged in age from 17 to 92 years (mean, 62.2 years), and comprised 20 men (mean age, 45.6 years) and 69 women (mean age, 66.5 years). The AO classification data on plain radiographs indicated A2 fracture in four patients, A3 fracture in 10 patients, C1 fracture in two patients, C2 fracture in 24 patients, and C3 fracture in 49 patients. Wrist arthroscopy was performed with vertical traction, and intracarpal soft tissues were examined. For assessment of the TFCC in the radiocarpal space, the Palmar classification was used. For assessment of the SLIL and LTIL in the midcarpal space, the Geissler classification was used.

TFCC injury was present in 59% of cases, SLIL injury in 54.5% of cases, and LTIL injury in 34.5% of cases. Only 17.1% of patients (14/82 patients) were negative for all three types of injury. In 81% of cases (72/89 patients), some intracarpal soft tissue injury was present in association with the fracture.

The fracture was complicated by TFCC injury in 59% of patients, SLIL injury in 54.5% of patients, and LTIL injury in 34.5% of patients, irrespective of the fracture type.