Use of Cobra External Fixator for treatment of Distal Radius Fractures

Abstract

Background: Distal radius fractures are one of the commonest injuries only after clavicle fractures. These fractures poses challenges to the treating surgeons as a result of which these fractures are sometime treated unacceptably and leads to poor outcome. Among various treatment options for these fractures wrist sparing Cobra external fixator is one of the options with an impressive stability and outstanding functional outcomes.Aims and Objectives: To determine whether this system can achieve adequate reduction of a variety of DRF, is able to maintain reduction despite hand and wrist movements, whether it compromises hand and wrist functions and leads to long term problems.Materials and Methods: From July 1, 2016 - June 30, 2017, all skeletally matured patients with acute distal radius fractures (AO-A2, B1, C1, C2) were adequately reduced and fixed with Cobra ex-fix. Immediately post-op patients were encouraged to start range of motion of the wrist as the pain decreased. The patients were followed up in 2,4 and 8 weeks and were analyzed clinically, radiologically, their functional outcomes and any complications.Results: Twenty-two patients were included in our study. Nine were males and 13 were females. Using the AO classification, 15 were classified as A2, 2 were B1, 3 were C1, and 2 were C2. The mean number of weeks the cobra fixator was maintained was 5.3 weeks. The Cobra ex-fix was able to achieve excellent maintenance of radial height and radial inclination and good maintenance of dorsal tilt. Recovery of functional activities according to Gartland and Werley’s functional scoring system was good to excellent in all patients at 8 weeks follow-up.Conclusion: The Cobra external fixation system is an outstanding device for use in fractures of the distal radius. It achieves superior anatomic correction and is dependable in maintaining fracture reduction even with hand and wrist use.Asian Journal of Medical Sciences Vol.9(6) 2018 84-89

Outcome of the Distal Radius Fractures Managed With Across Wrist External Fixator vs Buttress Plate

“…It is the second most common injury over 65 years, the complexity of these fractures is directly proportional to the Bone Mineral Density (BMD) and clinical outcome are inversely proportional to BMD. [1][2][3][4] Distal radial fractures (DRF) create a greatest challenge to operating surgeons. In terms of management, multiple options are present that include both surgical and conservative.…”

“…12 In contrast to the external fixator buttress plate shows superiority over the other procedures in terms of achieving anatomic correction and reduction of the fracture furthermore the buttress plate allows early recovery and recovery of wrist functions that help in the reduction of the disability and complications. 3 Other limitations of external fixator are wrist joint and finger's stiffness, injury to the sensory part of radial nerve, loss of reduction, and pin tract infections. 13 The main aim of this study was to assess the functional outcome of the DRF treated with across wrist external fixator vs buttress plate.…”