BACKGROUND A study was done to evaluate the effect of the ligamentotaxis in the management of intraarticular fractures of the distal radius. MATERIALS AND METHODS 34 patients were studied prospectively between March 2014 and February 2016. All patients had intraarticular fracture of distal end of radius and all were treated with ligamentotaxis after closed reduction with fluoroscopic guidance. The follow-up period was 12 months. At the time of surgery, the mean age was 45.29 years. RESULTS In all fracture cases, the mean of fracture union was 5.8 weeks. During the final follow-up, the mean range of motion was 55.30 in flexion, 56.60 in extension, 21.0 in ulnar deviation, 9.00 in radial deviation, 70.30 in pronation and 67.10 in supination. According to the scoring system of Gartland and Werley, the clinical and functional outcomes showed that 15 patients (44.1%) had excellent results, 14 (41.1%) had good results, 3 (8.8%) had fair results and 2 (5.8%) had poor results. CONCLUSION Closed reduction under fluoroscopic image guidance and the ligamentotaxis is useful and effective in the treatment of intraarticular fractures of the distal radius.

BACKGROUND Fractures of the distal end of radius are the most frequently occurring upper skeletal injuries managed by orthopaedic surgeons. Despite continuous refinement in treatment modalities, there is no consensus regarding the same. MATERIALS AND METHODS This prospective study was conducted on 80 patients with distal radial fractures after taking informed consent of the patients. Based on the fracture anatomy, different treatment protocols were assigned-a) Closed reduction and plaster cast application; b) Percutaneous K-wire fixation; c) External fixator application; and d) Open reduction and internal fixation with volar plate application. The fractures were classified with Frykman's classification. During the follow-up, functional parameters were assessed by the demerit point system of Gartland and Werley with Sarmiento et al modification and Mayo's wrist scoring. RESULTS Excellent to good results were obtained in most fractures treated by open reduction and internal fixation with volar plate and external fixation. Reduction was well-maintained, complications were less and functional parameters showed a significant improvement during the follow-up period. CONCLUSION External fixation and volar plating produce almost equivalent functional results in distal radial articular fractures with volar plating having better anatomical results than external fixation in the present study. Volar plate fixation of unstable distal radius fractures provides a stable construct that helps in early mobilisation, thereby achieving better functional outcomes and minimises chances of delayed/malunion. External fixator used for ligamentotaxis is an effective method of treating unstable extra-articular and complex intra-articular fractures of distal radius. Complication such as irregular articular surface, wrist pain, finger stiffness, malunion and K-wire loosening were observed. Thus, based on this study, we conclude that volar plating and external fixation have relatively better outcome for distal end radius fractures with minimum chance of implant failure and complications even in highly comminuted cases and cases having osteoporosis and should be preferred over the conventional treatment methods of percutaneous K-wire fixation and closed reduction with casting.