F. del Piñal

Unit of Hand-Wrist and Plastic Surgery, Hospital Mutua Montañesa, and Instituto de Cirugía Plástica y de la Mano, Santander, Spain

Abstract: Articular congruity is the most important prognostic factor when dealing with an articular fracture. The fluoroscope has been shown to be inaccurate to control articular step-offs in distal radius fractures (1, 2). The arthroscope, on the other hand, allows seeing inside a joint. Hence this instrument, not the fluoroscope, seems to be the appropriate tool to control articular congruency in distal radius fractures. Despite growing literature supporting its role (3–9), many surgeons are reluctant to systematically use the arthroscope when treating distal radius fractures. The possibility of compartment syndrome, the technical difficulties due to loss of vision and cumbersomeness without much benefit, are some of the arguments. However, the benefit of seeing inside a joint may be enormous when assessing congruency, associated ligament injuries, distal radio-ulnar joint instability and/or malunions. The aim of this paper is to present the logistics and technical hints as the way we manage distal radius fracture. By keeping the order presented, the procedure can be much more “friendly” than expected. A key factor in the procedure is not infusing water inside the joint during the arthroscopy, the so-called “dry technique”.