Dorsal Lunate Facet Fracture Reduction Using A Bone Reduction Forceps

BackhroundsThe dorsal lunate facet fragment represents part of a complex articular injury of the distalradius and are challenging to reduce through a standard volar approach. We proposereduction through a standard volar approach and intraoperative dorsal lunate facetreduction using a bone forceps. To evaluate the postoperative reduction we used computertomography (CT) scanMethodsWe retrospectively included 60 patients with a median follow-up of 44 weeks. Fracturereduction was evaluated using pre- and direct postoperative CT scans of the wrist measuringthe 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- andpostoperative radiographic measurements and to compare wrist range of motionResultsThere was a significant difference in flexion, extension, pronation and supination comparingthe injured to the uninjured wrist. In %87 of the patients there was complete radiographicreduction of the fractureConclusionsThis study shows that dorsal ulnar lunate facet fracture fragments in distal radius fracturescan be reduced through a standard volar approach with help of intraoperative bonereduction forceps. Using wrist computer tomography’s, we showed that %87 of the patientswith a dorsal ulnar lunate facet fragment had postoperative articular step or –gap of <1mm