The Effect of Ligament Injuries on Outcomes of Operatively Treated Distal Radius Fractures

Various authors have documented wrist ligament injuries in patients with distal radius fractures (DRFs). We conducted a study to determine whether scapholunate interosseous ligament (SLIL), triangular fibrocartilage complex (TFCC), or chondral injuries directly assessed with arthroscopy predict DRF outcomes. Forty-two patients who underwent open reduction and internal fixation of DRFs were enrolled in the study. At time of fracture surgery, patients were arthroscopically evaluated for SLIL and TFCC injuries and chondral surface damage. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was the primary outcome measure at 1 year. Analysis of variance was performed to evaluate for correlations between ligamentous/chondral injuries and DRF outcomes. Forty-five percent of patients had SLIL injuries, 50% had TFCC injuries, and 29% had articular cartilage injuries. There were no significant differences in DASH scores among the different injury groups and no significant differences in terms of secondary outcomes. SLIL and TFCC injuries occur in more than 70% of patients with operatively treated DRFs. These injuries appear not to have major negative effects on DRF outcomes up to 1 year after surgery.