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Arthroscopic arthrolysis with hardware removal versus hardware removal alone after intra-articular distal radius
Guillaume Boiteux1, Camille Brenac2, Rémy Dubian3
1Aix-Marseille University, St Marguerite Hospital, Institute for Locomotion, Department of Orthopaedics and Traumatology, Marseille, France.
Introduction:
Post-traumatic wrist stiffness after intra-articular distal radius fractures rarely improves with hardware removal alone once arthrofibrosis is established. Arthroscopic arthrolysis allows minimally invasive release of intra-articular adhesions.
Hypothesis:
Arthroscopic arthrolysis combined with hardware removal improves wrist motion and function compared with hardware removal alone.
Materials And Methods:
This single-center prospective study compared arthroscopic arthrolysis with hardware removal (combined) versus hardware removal alone (isolated) in patients with post-traumatic wrist stiffness after intra-articular distal radius fracture fixation. Outcomes were assessed preoperatively and at 1 year. The primary outcome of the study was the improvement in the flexion-extension arc. Secondary outcomes included changes in radial and ulnar deviation, pronation and supination and functional scores (QuickDASH).
Results:
Forty patients were included (15 combined, 25 isolated). At 1 year, flexion-extension gain was significantly greater in the combined group (32.6° vs 6.4°; p < 0.001). QuickDASH improved significantly only in the combined group. No major complications occurred.
Conclusion:
Arthroscopic arthrolysis combined with hardware removal provides superior improvement in wrist motion and function compared with hardware removal alone and should be considered in patients with established post-traumatic wrist stiffness.
Level Of Evidence:
III.
