Dorsal Lunate Facet Fracture Reduction Using a Bone Reduction Forceps

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Dorsal lunate facet fragments are complex distal radius injuries.
• Standard volar approaches present challenges for reducing these fragments.
• Intraoperative reduction using bone forceps is proposed as a solution.

Purpose of the Study:

• To evaluate the efficacy of a standard volar approach with intraoperative bone forceps for reducing dorsal ulnar lunate facet fragments.
• To assess postoperative reduction accuracy using computed tomography (CT) scans.
• To analyze the impact on wrist range of motion.

Main Methods:

• Retrospective study of 60 patients with a median follow-up of 44 weeks.
• Pre- and postoperative wrist CT scans were used to measure articular gap and step of the sigmoid notch.
• Clinical evaluation of wrist range of motion and bivariate analysis were performed.

Main Results:

• Complete radiographic reduction (<1 mm articular step or gap) was achieved in 87% of patients.
• Significant differences were observed in wrist range of motion (flexion, extension, pronation, supination) between injured and uninjured wrists.
• The technique proved effective for reducing dorsal ulnar lunate facet fragments.

Conclusions:

• A standard volar approach combined with intraoperative bone reduction forceps is effective for treating dorsal ulnar lunate facet fragments in distal radius fractures.
• Wrist CT confirms high accuracy in achieving reduction with minimal articular step or gap.
• This technique facilitates successful management of complex distal radius articular injuries.