Functional Outcome of Distal end Radius Fracture Treated by Ligamentotaxis by External Fixator with or without K Wire Augmentation

Abstract

Background: One of the most common injuries encountered in orthopedic practice are Distal Radius fractures. This comprises of 8%−15% of all fractures in adults 1 . The reason for comminuted DER fractures is high-energy trauma in young and low-energytrauma in elderly. They present as shear and impacted fractures involving the articular surface of the distal radius with displacement of the fragments 2-7 . External fixation for distal radius fracture relies on the principle of Ligamentotaxisin which, a distraction force applied to the carpus aligns the fragments by means of intact ligaments. The length and alignment of fracture fragment is guided by pull and counter pull which are otherwise difficult to control 8 . Objective: To study functional outcome of distal end radius fracture treated by ligamentotaxis with evaluation of functional results according to Disabilities of the Arm, Shoulder and Hand (DASH) score system. Material and Methods: We included 30 patients (Male 24 and Female 6) treated for distal end radius fracture during a period from 2015 to 2017. Patients were evaluated clinically by subjective assessment using DASH Scoring system. Result: After functional evaluation of patients according to the scheduled follow up with mean DASH Score of 76.08 at 1st month, 62.92 at 3rd month and 42.60 at 6th month, and was found to be Highly Significant (p<0.001) among all the compared groups. Conclusion: We concluded that external fixation and ligamentotaxis applied to complex distal radius fractures, when added with augmented K-wire fixation can provide direct augmentation of fracture stability and a good wrist function.

Functional outcomes of jess fixator application in fractures of distal end radius: A prospective study

“…On Comparison with Shukla et al [17] . In current study, there was no statistically significant difference in DASH scoring with respect to ▪ Age = no statistically significant difference in <50 year and >50-year age group found ▪ Sex = No statistically significant difference found between male and female patients ▪ Side = right / left ▪ Postoperative time (1.5 month/3 months/6 months) Mahajan et al [13] DASH scores (Mean + S.D.) DASH at 1 month = 76.08 ± 6.…”

“…Treatment part remains debatable as many treatment modalities are available which are may vary according to different fracture patterns and morphology, different age group, availability of implants and infrastructure, socioeconomic constraints etc. Different modes of treatment for fractures of distal end radius are there including most commonly performed closed manual reduction of fracture of distal end radius and slab or cast application, closed reduction and internal fixation with Kirschner wires (percutaneous pinning or intrafocal pinning) with or without slab / cast support, volar or dorsal plating, external fixation and Joshi's external stabilization system (JESS) depending on the fracture geometry and fracture type [13][14][15] . Collapse, loss of palmar tilt, radial shortening, and articular incongruity are frequent after closed treatment of unstable and comminuted intra-articular fractures of the distal radius, and these often result in permanent deformity, pain, and loss of function [14][15][16][17] .…”