External fixation of unstable fractures of the distal radius has been associated with many technical problems and complications. Hybrid external fixation has not been used in the clinical setting for distal radius fractures, but in theory this concept seemed reasonable. Our report of the first three cases of unstable Colles fractures describes the operative technique, as well as intraoperative hints and postoperative findings. The operation is fairly easy, mainly due to the possibility of intraoperative three-dimensional manipulation of the distal fragment. Postoperative stability was good, as no redisplacement was noted. The patients' acceptance of the device was high. In the postoperative period, one patient developed superficial infection at the Kirschner wire-skin interface that resolved with local care and systemic antibiotics; the fixator was removed after 6 weeks while in the other, noncomplicated cases the hybrid external fixator was kept for 8 weeks. In one case, signs of overdistraction of bone ends were detected on the postoperative radiograph, but painless postoperative adjustments of the fixator restored normal anatomy with no further complications. For valuable conclusions we are currently studying incoming cases in a prospective fashion.

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