JAAOS - 2026-08-01 - Journal Article; Review
Current Indications and Outcomes of Arthroscopic Treatment for Radial-Sided Wrist Injuries.
Vilai P, Kakar S
Topics
Key Takeaway
Wrist arthroscopy achieves articular step-off reduction to <2 mm in 85-100% of intra-articular distal radius fractures and improves scapholunate ligament staging accuracy over MRI alone, though long-term functional superiority over fluoroscopic-assisted fixation remains unproven.
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Summary
This narrative review evaluates the current indications and reported outcomes of wrist arthroscopy for radial-sided injuries including intra-articular distal radius fractures, scaphoid fractures, and scapholunate ligament injuries. Arthroscopy outperforms fluoroscopy and MRI for detecting occult ligamentous injuries and articular incongruity, with studies reporting incidental SL tears in 30-50% of intra-articular DRFs. Functional outcomes following arthroscopic-assisted fixation are comparable or marginally superior to fluoroscopic-assisted techniques in short-term series, but high-quality RCT data are lacking.
Key Limitation
As a narrative review without meta-analytic methodology, it cannot quantify the functional benefit of arthroscopic assistance over standard fluoroscopic fixation, limiting evidence-based adoption.
Original Abstract
Wrist arthroscopy has become an essential tool for treating intraarticular pathologies, with advancements in techniques and instruments expanding its indications over the past few decades. It is the benchmark for diagnosing intraarticular ligament pathologies, such as scapholunate ligament and triangular fibrocartilage complex injuries. In addition, it can be used an adjunct in the management of intraarticular fractures, particularly distal radius and scaphoid fractures. The objective of this article is to outline the role of arthroscopy in the management of common radial-sided wrist disorders and evaluate the surgical outcomes.