Purpose
Distal radius (DR) fracture repair using the volar locked plating technique typically
involves indirect fracture reduction, assessed using fluoroscopy, without direct visualization
of the articular surface. This method of fracture repair may be guided by the rationale
that volar radiocarpal ligament disruption may cause radiocarpal instability, although
direct articular visualization may facilitate improved fracture reduction. This study
investigated anatomical feasibility and articular surface visualization using volar
ligament-sparing radiocarpal arthrotomy pertinent to DR fracture repair.
Methods
Ten fresh-frozen cadaveric specimens of the upper extremity underwent volar arthrotomy
via the standard flexor carpi radialis approach with partial longitudinal sectioning
of the long radiolunate and partial transverse sectioning of the short radiolunate
ligaments to visualize the articular surface of the DR. Following arthrotomy, the
visible surface of the DR was analyzed using digital photography. The wrist was disarticulated,
and the fully exposed articular surface was photographed. The visible area of the
articular surface was quantified using digital imaging software by calculating the
ratio of the surface area visualized using the arthrotomy to the total articular surface
area.
Results
The percentage of the articular surface area of the DR visualized using the volar
arthrotomy was 76% ± 7.6% (range, 69%–90%), including both the scaphoid facet, lunate
facet, and scapholunate ridge.
Conclusions
Volar radiocarpal arthrotomy allows clinically relevant visualization of the articular
surface of the DR, including the scaphoid and lunate facets.
Clinical relevance
Radiocarpal arthrotomy may facilitate improved articular reduction during DR fracture
repair via the volar approach.
Key words
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Article info
Publication history
Published online: October 14, 2022
Accepted:
August 10,
2022
Received:
January 20,
2022
Publication stage
In Press Corrected ProofFootnotes
Dr Douleh received support the AFSH Resident Research Fast Track Grant, which specified that initial submission of any published work should be to the Journal of Hand Surgery. No benefits in any form have been received or will be received by the other authors related directly or indirectly to the subject of this article.
Identification
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
