Francisco del Piñal, MD, PhD, James Clune, MD

Hand Clinics Volume 33, Issue 4, November 2017, pages 669-675 – Copyright © 2017 Elsevier Inc. All rights reserved.

ABSTRACT (full text pdf. below)

Arthroscopic Management of Intra-articular Malunion in Fractures of the Distal Radius

Introduction 

Intra-articular malunion after a distal radius fracture can be debilitating. The diagnosis is often elusive and patients may arrive in your office in a delayed fashion. Unfortunately, during the delay, irreversible damage to the cartilaginous surfaces may occur. Patients are often diagnosed with complex regional pain syndrome, as there is chronic pain after the distal radius fracture that is in fact a malunion and being missed. This is unfortunate because the malunion, when diagnosed early, can be successfully treated and panarthrodesis can be avoided.

Key points 

• Intra-articular malunions of the distal radius are time sensitive. Delaying treatment for more than
  3 months can result in irreversible cartilage damage.
• Arthroscopic treatment of intra-articular malunions allows for better visualization, precision, and
  preservation of capsular blood supply than open techniques.
• Dry arthroscopy allows for adequate visualization of the wrist joint without excessive edema caused by wet arthroscopy.
• Resection arthroplasty is an acceptable alternative to wrist arthrodesis in certain cases.

Keywords Arthroscopic-assisted osteotomy, inside-out osteotomy, distal radius malunion, arthroscopic arthrolysis, intra-articular malunion radius.

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