Radiocarpal articular pressures during the reduction of distal radius fractures.

OBJECTIVES: To measure in vivo radiocarpal articular pressures during closed reduction and external fixation of distal radius fractures. DESIGN: Intraoperative measurements using a sterile pressure sensitive sensor specially constructed for this application. SETTING AND PATIENTS: 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. MAIN OUTCOME MEASUREMENTS AND RESULTS: 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. CONCLUSIONS AND CLINICAL RELEVANCE: 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.