Abstract
Background The dorsal lunate facet fragment represents part of a complex articular injury of
the distal radius and is challenging to reduce through a standard volar approach.
We propose reduction through a standard volar approach and intraoperative dorsal lunate
facet reduction using a bone forceps. To evaluate the postoperative reduction, we
used computed tomography (CT) scan.
Methods We retrospectively included 60 patients with a median follow-up of 44 weeks. Fracture
reduction was evaluated using pre- and direct postoperative CT scans of the wrist,
measuring the articular gap and step of the sigmoid notch. The range of motion was
evaluated clinically by the treating physician. Bivariate analysis was performed to
compare pre- and postoperative radiographic measurements and to compare wrist range
of motion.
Results When comparing the injured with the uninjured wrist, there was a significant difference
in flexion, extension, pronation, and supination. In 87% of the patients, there was
complete radiographic reduction of the fracture.
Conclusion This study shows that dorsal ulnar lunate facet fracture fragments in distal radius
fractures can be reduced through a standard volar approach with the help of an intraoperative
bone reduction forceps. Using wrist CT, we showed that 87% of the patients with a
dorsal ulnar lunate facet fragment had a postoperative articular step or gap of <1
mm.
Level of Evidence: This is a level IV, therapeutic study.
Keywords
radiographic evaluation - radius fracture - volar plate fixation
