Introduction and purpose: Distal radius fractures often affect the joint surface; their reduction is difficult and may be incomplete. In these cases the use of an arthroscope may help reconstruct the joint surface of the radius and allow the diagnosis of ligament injuries. The purpose of this study is to analyze the results of this type of fractures by means of this technique.

Materials and methods: Between November 2001 and January 2007 we reduced 24 fractures of the distal extremity of the radius that involved the joint surface with arthroscopic control. The mean age of the patients was 36 years (range: 21–55). We used Barbieri and Geissler’s classification. We recorded the approach route, arthroscopic ports, ligament injuries observed and complications. Also both radiological and functional results were assessed.

Results: In 18 of the 24 patients some sort of ligamentous or osteochondral lesion was found (lunate-pisiform ligament, scaphoid-lunate ligament or triangular cartilage). All achieved union after a mean period of 8 weeks. By means of x-rays we measured a mean intraarticular step-off of 0.29 mm and a mean interfragment distance of 0.5 mm. Joint balance and force were normal at the end of rehabilitation in 22 out of 24 cases.

Conclusion: The use of arthroscopy in intraarticular fractures of the distal extremity of the radius is a technique that helps achieve a more accurate reduction of the joint surface and allows the repair of lesions which would have been overlooked during traditional surgery without decreasing union rate or functional results.