Management of associated lesions in distal radius fractures

In this authoritative lecture, Dr. Nakamura outlines the current TFCC concept.

The arthroscopic resection of wrist ganglia is a sure technique, which allows a satisfactory resection of the cyst and of the adjacent articular capsule. The rate of recurrence does not seem as low as initially but stays in levels comparable to the best series of classical open techniques. The long follow-up of this report discusses the notion of true recurrence or return of a new cyst. Nevertheless, the satisfaction rate of the patients is very high particularly because there is neither cutaneous suture, nor immobilization of the wrist.

The evolution of scapholunate dissociations takes place towards osteoarthritis. The SLAC 3 stage associates a radio-scaphoid with a luno-capitate arthritis. The principle of this intervention is to perform a tendon interposition plasty between the scaphoid and the radius and a partial arthodesis between the capitatum and the lunatum.

The interest of wrist arthroscopy for the treatment of intra-articular fractures of the distal radius has been demonstrated in the literature for several years. This surgical technique requires specific instrumentation,
like a tower traction, small size optics and small tools. Once the stabilization of the wrist has been performed (using K-wires or plates), an arthroscopic control allows to appreciate the reduction of the fracture, and to diagnose and treat ligamentous injuries. Reduction of the fracture is
sometimes not sufficient and can be carried out under arthroscopic control using K-wires as a joystick. This surgical technique needs a learning curve to be able to treat difficult articular fractures of the distal radius. Using arthroscopy, the follow-up of operated articular fractures of the distal radius is easier for the surgeon and the patient.

In this key lecture, Dr. Cognet covers the surgical treatment of scaphoid fractures with arthroscopic control.

In this key lecture, Dr. Delgado focuses on scapholunate tears and their classification.

In this key lecture, Dr. Camus looks into the management of associated lesions in distal radius fractures

In this key lecture, Professor Liverneaux presents telemicrosurgery: robot-assisted microsurgery.

In this key lecture, Dr. Kebrle covers the principles of TFCC repair.