A study of external fixation of distal end radius fractures

Abstract

Background & Objectives: Preservation of the articular congruity is the principle prerequisite for successful recovery following distal radius fractures. The best method of obtaining and maintaining an accurate restoration of articular anatomy however, remains a
topic of considerable controversy. External fixation as a method of treatment for distal end of radius fracture has more than 60 years of documented clinical experience. The main aim of this study is to evaluate the results obtained by treatment of distal end radius fractures by external fixation.
Methods: In a prospective controlled study, 30 cases of unstable distal end radius fractures with intra-articular extension were treated with uniplanar bridging type of external fixation using the principle of ligamentotaxis and augmentation by Kwires. Mean age of the patients was 39.03 years, External fixator was applied for a mean duration of 6.06 weeks and cases were followed up for an average of 36.8 weeks post operatively.
Results: Assessed as per De merit point system of Gartland and Werley (modified by Sarmiento 1975) for functional results at the end of 6 months of follow up. Excellent to good functional result was noted in 80%.
Conclusion: External fixation and ligamentotaxis provides better functional and anatomical results in comminuted intra-articular and unstable extra-articular wrist injuries. The successful use of external fixator for distal end radial fracturesrequires careful assessment of fracture pattern, appropriate patient selecting, meticulous surgical techniques appropriate choice of fixation, judicious augmentation with internal fixation and bone grafting, careful post operative monitoring and aggressive early institution of rehabilitation. The final functional result of treatment of distal radius fractures not only depends on the anatomical restoration of the articular surface but also on the associated soft tissue injuries and articular damage.