Radiocarpal articular pressures during the reduction of distal radius fractures.

Abstract

To measure in vivo radiocarpal articular pressures during closed reduction and external fixation of distal radius fractures. Intraoperative measurements using a sterile pressure sensitive sensor specially constructed for this application. Ten patients with a closed distal radius fracture stabilized by radiometacarpal external fixation. Radiocarpal pressures measured during transarticular distraction, wrist palmar flexion, wrist ulnar inclination, and fracture reduction. Transarticular distraction resulted in a substantial decrease of the articular pressure, averaging -158.1 mmHg. Palmar flexion resulted in a mean pressure increase of 91.8 mmHg. The reduction of the fracture using a combination of distraction, palmar flexion and ulnar deviation resulted in either an increase or decrease of articular pressure, but always with a tendency toward progressive normalization of the pressure, with a mean slope of 3.2 mmHg/min. The phenomena leading to the reduction of distal radius fractures could be related in part to a decrease of the intraarticular pressure, which may be responsible for a suction effect on the intraarticular bone fragments.