Operative Treatment of Associated Carpal Ligament Injuries

There was one Level II trial that compared the arthroscopic reduction and fixation of distal radius fracture combined with arthroscopic treatment of associated intra carpal ligament and TFCC injuries to fluoroscopic reduction and fixation of the radius alone.⁵⁵ The authors demonstrated that arthroscopy is a valuable adjunctive method for evaluating and treating these lesions which are not detectable on standard radiographs. One limitation of the study is the possibility of preexisting carpal lesions. An additional limitation is that the true incidence of carpal ligament lesions in the fluoroscopy group was unknown. These limitations resulted in a downgrading of the recommendation to “Limited.” In the arthroscopy group, the DASH scores were clinically important at the three month interval. Regardless of arthroscopy, the difference in function as determined by DASH scores was inconclusive at 1 and 2 years postoperatively.