Combination of Wrist Arthroscopy with Volar Locking Plate Fixation for Distal Radius Fracture

Since 2002, the volar locking plate (VLP) technique for distal radius fractures has been popularized explosively. It achieves rigid fixation of the distal fragment of the radius, even in comminuted intra-articular fractures, introduces earlier rehabilitation, and results in successful outcomes. In daily practice, the VLP has been applied to extra- and intra-articular distal radius fractures. Wrist arthroscopy has been popularized since the 1980s. It is now the gold standard for diagnosis and treatment of soft tissue injuries of the wrist, such as triangular fibrocartilage complex (TFCC) injuries and scapholunate (SL) ligament injuries. Usage of wrist arthroscopy expands to fracture repair, including intra-articular distal radius fracture and scaphoid fracture/nonunion. For the reduction of the intra-articular fragment, there is still a controversy about the use of additional wrist arthroscopy or fluoroscopy guidance only. Wrist arthroscopy indicates a better view of the fragment, a lesser gap and step-off of the distal radius fragment, and less radiation, while fluoroscopic guidance of the fragment reduction indicates faster operation time and fewer complications of arthroscopy, such as swelling. Even in the extra-articular fracture of the radius, there may be advantages of wrist arthroscopy, such as exploring TFCC and SL ligament injuries. This issue includes the “Editor's pick” of “What have we learned in the wrist joint of distal radius fracture through wrist arthroscopy?” described by Dr Yukio Abe's group. This manuscript describes the precise technique of “plate-presetting arthroscopic reduction technique” (PART) for intra-articular comminuted fractures of the distal radius and his clinical experience of 700 distal radius fractures. Wrist arthroscopy was used in all cases, and there were no major complications in this series. The authors also mentioned that (1) accurate reduction of intra-articular fragments is possible compared with fluoroscopic reduction; (2) intra-articular fragments (free body), undetected with preoperative radiograph and computed tomography (CT), can be recognized; (3) screw protrusion into joint surface can be monitored; (4) intra-articular soft tissue injury associated with fracture can be evaluated and treated. Interesting wrist papers, such as the distal radius fracture, intracarpal fusion, wrist biomechanics, arthroscopic wafer procedure, systematic review of malunion of the distal radius, and anatomy of the scaphotrapeziotrapezoidal (STT) joint, are included in this issue. There are four interesting case reports in the e-issue. Don't miss it. Publication History Article published online: 28 July 2026 © 2026. Thieme. All rights reserved. Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA