INTRODUCTION: Post-traumatic wrist stiffness after intra-articular distal radius fractures rarely improves with hardware removal alone once arthrofibrosis is established. Arthroscopic arthrolysis allows minimally invasive release of intra-articular adhesions. HYPOTHESIS: Arthroscopic arthrolysis combined with hardware removal improves wrist motion and function compared with hardware removal alone. MATERIALS AND METHODS: This single-center prospective study compared arthroscopic arthrolysis with hardware removal (combined) versus hardware removal alone (isolated) in patients with post-traumatic wrist stiffness after intra-articular distal radius fracture fixation. Outcomes were assessed preoperatively and at 1 year. The primary outcome of the study was the improvement in the flexion-extension arc. Secondary outcomes included changes in radial and ulnar deviation, pronation and supination and functional scores (QuickDASH). RESULTS: Forty patients were included (15 combined, 25 isolated). At 1 year, flexion-extension gain was significantly greater in the combined group (32.6° vs 6.4°; p < 0.001). QuickDASH improved significantly only in the combined group. No major complications occurred. CONCLUSION: Arthroscopic arthrolysis combined with hardware removal provides superior improvement in wrist motion and function compared with hardware removal alone and should be considered in patients with established post-traumatic wrist stiffness. LEVEL OF EVIDENCE: III.
Boiteux et al. (Sun,) studied this question.