Abstract Background: Intra-articular distal radius fractures in athletes present unique challenges requiring both anatomic restoration and optimal soft-tissue management. Objectives: This study evaluates the outcomes of arthroscopic-assisted reduction and internal fixation (ARIF) for intra-articular distal radius fractures in athletes, with emphasis on associated soft-tissue injuries and return to sport. Materials and Methods: We retrospectively reviewed 61 athletes (38 males, 23 females; mean age 28.7 ± 6.3 years) with intra-articular distal radius fractures treated with ARIF between 2018 and 2022. All patients underwent a comprehensive arthroscopic assessment of intra-articular fragments and soft-tissue structures. Functional outcomes were evaluated using the Modified Mayo Wrist Score (MMWS) and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) score. Results: Mean follow-up was 18.7 ± 4.3 months. Associated soft-tissue injuries were identified in 38 patients (62.3%), including Triangular Fibrocartilage Complex tears (37.7%), Scapholunate Interosseous Ligament injuries (29.5%), Lunotriquetral Interosseous Ligament injuries (14.8%), and Distal Radioulnar Joint instability (11.5%). Mean MMWS improved from 34.7 ± 8.5 preoperatively to 87.8 ± 6.4 at final follow-up ( P < 0.001). Mean Quick DASH score improved from 68.2 ± 12.4 to 8.7 ± 5.2 ( P < 0.001). Mean time to return to sport was 14.2 ± 3.1 weeks, with professional athletes returning earlier than amateurs (12.3 ± 2.4 vs. 15.1 ± 3.3 weeks, P = 0.012). Patients with AO type C fractures demonstrated longer return-to-sport times compared to type B fractures (15.3 ± 2.8 vs. 12.7 ± 2.1 weeks, P = 0.023). Patients with TFCC injuries showed increased ulnar-sided wrist pain at final follow-up compared to those without (1.7 ± 1.0 vs. 0.8 ± 0.7, P = 0.031). Conclusions: ARIF of intra-articular distal radius fractures in athletes provides excellent functional outcomes with high rates of return to pre-injury activity levels. The high prevalence of concomitant soft-tissue injuries highlights the importance of comprehensive assessment beyond osseous structures to optimize athletic performance and long-term wrist function.
Yeh et al. (Thu,) studied this question.