Purpose
The use of wrist arthroscopy to assist fixation of distal radius fractures with volar
locking plates (VLPs) has been gaining popularity in recent years; however, there
is no consensus on its benefits. This meta-analysis compares outcomes of arthroscopic-assisted
VLP to fluoroscopic-assisted VLP in distal radius fractures through a systematic review
of the published literature.
Methods
A systematic search of publications from databases (Medline, EMBASE, Scopus, and Cochrane)
was obtained from inception to May 2020. A random-effects meta-analysis was used to
calculate effect sizes. Outcomes included postoperative radiographic reduction (gap,
stepoff, radial inclination, volar tilt, and ulnar variance), procedural outcomes
(operative time, additional soft tissue injuries and complications), and functional
outcomes (range of motion; visual analog scale score; Disabilities of the Arm, Shoulder,
and Hand score; Patient-Rated Wrist Evaluation score; Mayo clinic score; and grip
strength).
Results
Six studies, involving 280 patients, met the final inclusion criteria. The meta-analysis
for postoperative stepoff was statistically significant, favoring arthroscopic-assisted
VLP. In addition, there was greater identification of associated soft tissue injuries,
increased wrist extension, and a longer operative duration when performing arthroscopic-assisted
VLP fixation. There were no differences in other postoperative radiographic outcomes,
complications, or functional outcomes.
Conclusions
The current literature suggests that arthroscopic-assisted VLP is a useful adjunct
to intra-articular reduction and treatment of associated soft tissue injuries in distal
radius fractures. Considerations should include operative time, costs, and the additional
training required. Further studies are needed to assess functional outcomes.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: February 12, 2022
Accepted:
November 10,
2021
Received:
February 7,
2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
