RADIOCARPAL ARTICULAR PRESSURES DURING THE REDUCTION OF DISTAL RADIUSFRACTURES

Objectives: To measure in vivo radiocarpal articular pressures during closed reduction and external fixation of distal radius fractures. Des ign: Intraoperative measurements using a sterile pressure-sensitive se nsor specially constructed for this application. Setting and Patients: Ten patients with a closed distal radius fracture stabilized by radio metacarpal external fixation. Radiocarpal pressures measured during tr ansarticular distraction, wrist palmar flexion, wrist ulnar inclinatio n, and fracture reduction. Main Outcome Measurements and Results: Tran sarticular distraction resulted in a substantial decrease of the artic ular pressure, averaging -158.1 mmHg. Palmar flexion resulted in a mea n pressure increase of 91.8 mmHg. The reduction of the fracture using a combination of distraction, palmar flexion and ulnar deviation resul ted in either an increase or decrease of articular pressure, but alway s with a tendency toward progressive normalization of the pressure, wi th a mean slope of 3.2 mmHg/min. Conclusions and clinical relevance: T he phenomena leading to the reduction of distal radius fractures could be related in part to a decrease of the intraarticular pressure, whic h may be responsible for a suction effect on the intraarticular bone f ragments.