title: Wrist arthroscopy in the management of articular distal radius fractures.
abstract: Fractures of the distal radius account for 15% of all fractures. The use of arthroscopy is increasingly popular in the last years, with the goal to achieve a better anatomical reduction of the articular fragments.
  
  
  
  We searched the literature on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'wrist', 'distal radial fracture', 'distal radius fracture' and 'arthroscopy'. Twenty-eight studies were identified. The quality of the studies was assessed using the Coleman Methodological Score.
  
  
  
  Arthroscopy allows to detect intra-articular, ligamentous and triangular fibrocartilage complex injuries in an acute setting with a better prognosis. Arthroscopy increases the quality of the intra-articular reduction compared to fluoroscopy.
  
  
  
  The main limitation of the selected studies is the short follow-up: the average follow-up in 20 studies was 12 months, a period long enough to assess functional outcomes, but not to assess the occurrence of post-traumatic degenerative changes and their impact on function. Better stratification of the fracture population is needed.
  
  
  
  The shorter recovery time and the low incidence of adverse effects are the main advantages of this new technology.
  
  
  
  There is need to perform randomized controlled trials reporting on the use of volar locking plates as, at the present time, they are the standard management for these fractures. In addition, the different pattern of fracture should be better classified to manage the patients who will benefit after the management.
authors.affiliation: Department of Orthopaedic Surgery, University of Naples Federico II, via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Smeraglia
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Ospedale Vaio Via Don Enrico Tincati, 5, 43036 Fidenza (PR), Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Del Buono
authors.affiliation: Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84081 Baronissi, Salerno, Italy Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D001182:Arthroscopy / Q000379:methods; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery*; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000503:physiopathology / Q000601:surgery*
keywords: distal radial fracture; distal radius fracture; wrist arthroscopy