External fixator for intra-articular fractures of distal end of radius: A prospective study

Abstract

Background: The primary goals of distal radius fracture fixation are to put the pieces back where they belong and, most importantly, to do so by a method that does not compromise hand function. Displaced comminuted intra-articular fractures of the distal radius are difficult to treat successfully by traditional non-operative methods. Thus, external fixation plays a very distinct role. Methods: Twenty adult patients with closed comminuted intra-articular fractures of the distal radius were treated by closed reduction and immobilization with a external wrist fixator during a 2-year period [September 2003 to September 2005. Six weeks later, the fixator was removed. The patients then were observed for an average of 8 months [6-10 months]. Results: An excellent outcome was seen in 2 patients (10%), a good outcome in 12 patients (60%), and a fair outcome in 5 patients (25%) and poor outcome in 1 patient (5%). Minor complication, pin tract infection was present in one (5%) patient but recovered completely after removal of the fixator. Conclusions: External fixator is simple and inexpensive. Displaced severely comminuted intra-articular fractures should be treated with an external fixator. It effectively stabilises fractures y et al lowing for hand motion and prevents stiffness. The radial angle and volar tilt should be achieved for an optimal outcome, it is difficult to regain volar tilt by ligamentotaxis and maintain it by external fixators. Most complications are minor and easily treated and do not affect outcome. The ease of use of the implants and successful track record make it an extremely versatile tool for treating complex fractures of the distal radius.