Wrist articular fractures are more difficult to treat and rehabilitation takes longer. Furthermore, these joint fractures are frequently accompanied by ligament lesions of the carpal bones.
For these reasons, it is strongly recommended to check the interior of the wrist joint. This check can be done with wrist arthroscopy. Therefore, fracture reduction can be improved, "step of stairs" can be eliminated under arthroscopic control and ligament rupture of carpal bones can be treated.
WALANT anesthesia (Wide Awake Local Anesthesia No Tourniquet) designates a new local anesthesia technique. This technique which allows to maintain the arm or fingers mobility offers several significant advantages:
* Greater precision of the surgical procedure. * A reduction in discomfort, risks and related adverse effects to anesthesia. * Faster recovery.
WALANT technique is very comfortable for patient and fits perfectly with principles of Enhanced Recovery in Surgery.
In this context, this study is based on the hypothesis that it is possible to combine arthroscopy and the WALANT anesthesia technique for reducing wrist fractures
Patient, male or female, aged ≥ 18 and < 70 years
Patient with a displaced articular fracture of the distal radius (unilateral wrist fracture)
Patient treated on ambulatory way
Patient affiliated to or beneficiary of a social security system
Patient with previous infection or wrist bone surgery
Patient with multiple fractures or with bilateral wrist fractures
Patient with associated fracture with the wrist fracture
Patient with "pathological" bone
Single group
Walanpoigne
Procedure/SurgeryIntervention will combine WALANT anesthesia with arthroscopy to reduce a joint fracture of the wrist
Failure percentage
A failure is defined by the impossibility of achieving the surgery under WALANT anesthesia. Practically, this translates either to stopping the procedure, either by intra-operative sedation (Protoxide nitrogen, deep hypnosis, general anesthesia) in emergency
Pain assessment
Pain will be assessed with a VAS (Visual Analogic Scale). Minimum value is 0 and maximum value is 10. 0 means no pain whereas higher scores mean more and more pain.
Patient experience
Patient experience will be evaluated using the e-satis questionnaire. Minimum value is 0 and maximum value is 100. 0 means patient is not satisfied whereas higher scores mean patient is more and more satisfied.
Wrist mobility
Wrist mobility will be assessed with flexion/extension and pronosupination (measured in degrees with the goniometer)
Functional characteristics of the wrist
Functional characteristics of the wrist will be assessed with PWRE (Patient-Rated Wrist Evaluation) questionnaire. Each question is rated from 0 to 10. Higher scores mean a worse outcome.
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