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J Wrist Surg 2024; 13(01): 086-095
DOI: 10.1055/s-0042-1757768
Survey or Meta-Analysis

Arthroscopic Assistance in Surgical Management of Distal Radius Fractures: A Systematic Review and Meta-analysis

Javier Román-Veas
1   Clínica Indisa, Santiago, Chile
,
Héctor Gutiérrez-Espinoza 
2   Escuela de Fisioterapia, Universidad de las Américas, Quito, Ecuador
,
Christian Campos-Jara
3   Exercises and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
,
Darío Martínez-García
4   Department of Physical Education and Sports, Faculty of Sports Sciences, University of Granada, Granada, Spain
› Author Affiliations Funding No funding was obtained to conduct this meta-analysis.
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Abstract

Background Wrist arthroscopy has become a commonly used tool for the management of adults with distal radius fractures (DRFs), although its implementation requires technical competence. This systematic review and meta-analysis appraised the available evidence concerning the contribution of wrist arthroscopy to the functional and radiological outcomes of patients with DRFs operated with arthroscopic assistance.

Methods Randomized control trials were identified through five principal electronic databases on May 31, 2022: Web of Science, Scopus, EBSCO, Embase, and PubMed. Two authors independently performed the search and data extraction and assessed risk of bias (RoB) using the Cochrane RoB tool.

Results A total of 1,780 relevant abstracts and citations were extracted in the preliminary search, which yielded 6 trials that met the eligibility criteria, and 3 studies were included in the quantitative synthesis. The overall pooled mean difference (MD) estimate showed no significant difference in the Disabilities of the Arm, Shoulder, and Hand scores between surgical groups with and without arthroscopic assistance (MD = 0.77 points, 95% confidence interval = −6.58 to 5.03, p = 0.79), with substantial heterogeneity (I2 = 85%).

Conclusion There was low-quality evidence that wrist arthroscopy conveyed not clinically or statistically significant difference to functional outcomes of patients with DRFs. However, our findings are limited by the numbers of studies included and lack of long-term follow-up, although they do provide a good starting point for future quality research.

Keywords

arthroscopy - arthroscopy assistance - distal radius fracture - randomized controlled trial - meta-analysis


Publication History

Received: 18 July 2022

Accepted: 05 September 2022

Article published online:
13 October 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 Karl JW, Olson PR, Rosenwasser MP. The epidemiology of upper extremity fractures in the United States, 2009. J Orthop Trauma 2015; 29 (08) e242-e244
    CrossrefPubMedGoogle Scholar
  • 2 Woolnough T, Axelrod D, Bozzo A. et al. What is the relative effectiveness of the various surgical treatment options for distal radius fractures? A systematic review and network meta-analysis of randomized controlled trials. Clin Orthop Relat Res 2021; 479 (02) 348-362
    CrossrefPubMedGoogle Scholar
  • 3 Stephens AR, Presson AP, McFarland MM. et al. Volar locked plating versus closed reduction and casting for acute, displaced distal radial fractures in the elderly: a systematic review and meta-analysis of randomized controlled trials. J Bone Joint Surg Am 2020; 102 (14) 1280-1288
    CrossrefPubMedGoogle Scholar
  • 4 Mehling I, Müller LP, Rommens PM. Comparative biomechanical studies on implant systems for the treatment of distal radius fractures: what are the conclusions for clinical practice? [in German]. Handchir Mikrochir Plast Chir 2012; 44 (05) 300-305
    PubMedGoogle Scholar
  • 5 Bain GI, Baker A, Whipple TL, Poehling GG, Mathoulin C, Ho P-C. History of wrist arthroscopy. JWrist Surg 2022; 11 (02) 96-199
    PubMedGoogle Scholar
  • 6 Badia A. Small joint arthroscopy. In: Geissler W. ed. Wrist and Elbow Arthroscopy. New York, NY: Springer; 2015: 321-340
    Google Scholar
  • 7 Lutsky K, Boyer MI, Steffen JA, Goldfarb CA. Arthroscopic assessment of intra-articular distal radius fractures after open reduction and internal fixation from a volar approach. J Hand Surg Am 2008; 33 (04) 476-484
    CrossrefPubMedGoogle Scholar
  • 8 del Piñal F, García-Bernal FJ, Pisani D, Regalado J, Ayala H, Studer A. Dry arthroscopy of the wrist: surgical technique. J Hand Surg Am 2007; 32 (01) 119-123
    CrossrefPubMedGoogle Scholar
  • 9 Lameijer CM, Ten Duis HJ, Vroling D, Hartlief MT, El Moumni M, van der Sluis CK. Prevalence of posttraumatic arthritis following distal radius fractures in non-osteoporotic patients and the association with radiological measurements, clinician and patient-reported outcomes. Arch Orthop Trauma Surg 2018; 138 (12) 1699-1712
    CrossrefPubMedGoogle Scholar
  • 10 Leclercq C, Mathoulin C. Members of EWAS. Complications of wrist arthroscopy: a multicenter study based on 10,107 arthroscopies. J Wrist Surg 2016; 5 (04) 320-326
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 (71) n71
    CrossrefPubMedGoogle Scholar
  • 12 Higgins JPT, Thomas J, Chandler J. et al. Cochrane handbook for systematic reviews of interventions version 6.3; updated February 2022. Cochrane. Available at: http://www.training.cochrane.org/handbook
    PubMedGoogle Scholar
  • 13 Cochran WG. The combination of estimates from different experiments. Biometrics 1954; 10 (01) 101-129
    CrossrefPubMedGoogle Scholar
  • 14 Guyatt GH, Oxman AD, Vist GE. et al; GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336 (7650): 924-926
    CrossrefPubMedGoogle Scholar
  • 15 Balshem H, Helfand M, Schünemann HJ. et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 2011; 64 (04) 401-406
    CrossrefPubMedGoogle Scholar
  • 16 Doi K, Hattori Y, Otsuka K, Abe Y, Yamamoto H. Intra-articular fractures of the distal aspect of the radius: arthroscopically assisted reduction compared with open reduction and internal fixation. J Bone Joint Surg Am 1999; 81 (08) 1093-1110
    CrossrefPubMedGoogle Scholar
  • 17 Kasapinova K, Kamiloski V. Influence of associated lesions of the intrinsic ligaments on distal radius fractures outcome. Arch Orthop Trauma Surg 2015; 135 (06) 831-838
    CrossrefPubMedGoogle Scholar
  • 18 Lee SK, Kim KJ, Cha YH, Choy WS. Conservative treatment is sufficient for acute distal radioulnar joint instability with distal radius fracture. Ann Plast Surg 2016; 77 (03) 297-304
    CrossrefPubMedGoogle Scholar
  • 19 Selles CA, Mulders MAM, Colaris JW, van Heijl M, Cleffken BI, Schep NWL. Arthroscopic debridement does not enhance surgical treatment of intra-articular distal radius fractures: a randomized controlled trial. J Hand Surg Eur Vol 2020; 45 (04) 327-332
    CrossrefPubMedGoogle Scholar
  • 20 Varitimidis SE, Basdekis GK, Dailiana ZH, Hantes ME, Bargiotas K, Malizos K. Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction?. J Bone Joint Surg Br 2008; 90 (06) 778-785
    CrossrefPubMedGoogle Scholar
  • 21 Yamazaki H, Uchiyama S, Komatsu M. et al. Arthroscopic assistance does not improve the functional or radiographic outcome of unstable intra-articular distal radial fractures treated with a volar locking plate: a randomised controlled trial. Bone Joint J 2015; 97-B (07) 957-962
    CrossrefPubMedGoogle Scholar
  • 22 Saab M, Guerre E, Chantelot C, Clavert P, Ehlinger M, Bauer T. SoFCOT. Contribution of arthroscopy to the management of intra-articular distal radius fractures: Knowledge update based on a systematic 10-year literature review. Orthop Traumatol Surg Res 2019; 105 (08) 1617-1625
    CrossrefPubMedGoogle Scholar
  • 23 Aguirre GL, Cristiani WM, Robles C, Gutiérrez-Olivera N, Paganini F, Allende-Nores C. Distal radius intraarticular fractures: fluoroscopy reduction versus arthroscopic assistance. Systematic review [in Spanish]. Acta Ortop Mex 2020; 34 (06) 226-432
    PubMedGoogle Scholar
  • 24 Shihab Z, Sivakumar B, Graham D, Del Piñal F. Outcomes of arthroscopic-assisted distal radius fracture volar plating: a meta-analysis. J Hand Surg Am 2022; 47 (04) 330-340.e1
    CrossrefPubMedGoogle Scholar
  • 25 Lameijer CM, Ten Duis HJ, Dusseldorp IV, Dijkstra PU, van der Sluis CK. Prevalence of posttraumatic arthritis and the association with outcome measures following distal radius fractures in non-osteoporotic patients: a systematic review. Arch Orthop Trauma Surg 2017; 137 (11) 1499-1513
    CrossrefPubMedGoogle Scholar