To evaluate the long-term results of external fixation of distal radius fractures.
A retrospective follow-up study (median follow-up, 5.3 years) of 49 patients with 50 distal radius fractures treated with an external fixator was carried out. An external fixator (Minifixator, Stratec Medical, Waldenburg, Switzerland) was used. The operative procedure is described in detail. A personal evaluation including clinical and radiologic assessment of both wrists was performed.
The functional results, including the parameters strength, daily activities, range of motion, and presence of pain, as well as an anatomic score, the presence of osteoarthritis, the quality of reduction, and complications were recorded. Functional and anatomic results indicated excellent to good ratings in more than 80% of the cases.
The external fixator is a versatile tool in the treatment of intra-articular and extra-articular fractures of the distal radius. The rate of algodystrophy (reflex sympathetic dystrophy) was 6%, and wrist stiffness was not found in our series.
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"The most common instrumentation used, restores the anatomy of the distal forearm by continuous ligamentotaxis across the radiocarpal joint. It is also effective in simple intraarticular fractures without additional manipulation [18, 21–23]. Various designs of transarticular (“bridging”) fixators have been invented; they are easy to apply, allowing some postoperative adjustments, and are fairly well tolerated by patients [1, 4, 5, 7–9, 13, 24]. "
[Show abstract][Hide abstract] ABSTRACT: External fixation is a well-established procedure for the treatment of unstable fractures of the distal radius, but its use is beset with complications. A plethora of theoretical and experimental data suggests that nonbridging fixators are superior for this setting. A new concept for the use of hybrid external fixation seemed reasonable and was applied for this study.
We report on the first 14 cases of unstable, extraarticular fractures of the distal radius with a one-year follow-up and describe the operative technique. All were treated at 3-5 weeks after injury; nevertheless, closed reduction after the fixator elements were fixed to the bone was always possible.
We had no intraoperative complications, but in the follow-up period three cases of algodystrophy and one transient irritation of the ulnar nerve ensued. One case developed superficial infection at the K-wire entry site that resolved with local care and systemic antibiotics. No redisplacements were observed. Early and late (at one year) evaluation of results revealed good and very good anatomic results (Lidström system) and two satisfactory (cases with algodystrophy), eight very good and four good functional outcomes (Gartland-Werley system). The patients' acceptance of the device was high.
Hybrid external fixation of neglected distal radial fractures results in good outcomes if care is taken to prevent overdistraction of bone fragments.
Journal of Orthopaedics and Traumatology 01/2009; 9(4):195-200. DOI:10.1007/s10195-008-0023-5
[Show abstract][Hide abstract] ABSTRACT: B ackground : D i stal radial fr acture s orc among the most comnnnorlhopedic iniuries. An unac ce p lable re duc tio n re sul ts infunc tio nal Io ss for the extremiry and this is the reasonwhy much attention lws been put in the treatment of distal r adial fr a ct ur e s. T he C o br a exte r nal ft xat or has increasingly been used in the treatntent of dktal radial fractures. Objective: The purpose of this study was to compare the rigidity of four different configurations of the Cobra external fixntor.