To compare clinical effects between wrist arthroscopy and intraoperative fluoroscopy assisted open reduction and volar plate internal fixation in the treatment of intra-articular distal radius fractures.

A retrospective analysis was conducted on the clinical data of 151 patients with intra-articular distal radius fractures who received surgical treatment in Ankang Central Hospital from April 2020 to April 2023. According to different adjuvant treatment methods, the patients were divided into the traditional group (traditional intraoperative fluoroscopy assisted surgery, 78 cases) and the arthroscope group (wrist arthroscope assisted surgery, 73 cases). Intraoperative blood loss, length of hospital stay, fracture healing time, duration of surgery, the disabilities of the arm, shoulder and hand (DASH) scores, patient-rated wrist examination (PRWE) scores, wrist range of motion, whole blood low shear viscosity, whole blood high shear viscosity and plasma viscosity of the two groups were recorded. The complication incidence was also recorded. The independent-sample t test and chi square test were used for statistical analysis.

Intraoperative blood loss, length of hospital stay and fracture healing time of the arthroscope group were significantly less and shorter than those of the traditional group, but the duration of surgery was significantly longer than that in the traditional group (t=2.954, 3.231, 5.432, 3.383, all P<0.05). Six months after surgery, DASH and PREW scores of the arthroscope group were significantly lower than those of the traditional group. The ranges of flexion, pronation and supination, ulnar and radial ranges of motion, and range of dorsiflexion were significantly larger than those in the traditional group (t=2.903, 2.261, 2.265, 2.283, 2.190, 3.976, 6.105, 3.289, all P<0.05). Twelve months after surgery, there were decreases in DASH and PREW scores, and increases in the ranges of flexion, pronation and supination, ulnar and radial ranges of motion, and the range of dorsiflexion in both groups. However, there was no statistically significant difference between the groups (t=1.919, 0.527, 0.807, 0.438, 1.003, 1.202, 1.009, 1.049, all P>0.05). Three months after surgery, whole blood low shear viscosity, whole blood high shear viscosity and plasma viscosity in both groups decreased, and these indicators in the arthroscope group were significantly lower than those in the traditional group (t=3.123, 2.082, both P<0.05). The incidence of adverse reactions showed no statistically significant difference between groups (P=0.444).

For intra-articular distal radius fracture, wrist arthroscopy assisted surgery causes less intraoperative blood loss, and is more conducive to fracture healing. It can improve short-term wrist function, and reduce the impact on microcirculation in the body.