Long-term results of the external fixation of distal radius fractures.

Department of Surgery, University Hospital of Basel, Switzerland.
The Journal of trauma (Impact Factor: 2.96). 07/1998; 44(6):970-6. DOI: 10.1097/00005373-199806000-00007
Source: PubMed

ABSTRACT 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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Available from: Daniel Rikli, Aug 25, 2015
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    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.
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    ABSTRACT: Introduction: Rehabilitation is an integral part of the concept for wrist fractures treated through immobilization. Our aim was to determine the effect of two different therapy concepts on the outcome in a prospective study: treatment by a professional physical therapist and an unassisted home exercise program. Materials and Methods: 42 volunteers with conservatively treated wrist fractures were randomized in treatment by a professional physical therapist (N = 21) with 12 sessions, and an unassisted home exercise program (N = 21). Follow-up six weeks later involved evaluation of range of motion, grip strength using a Jamar dynamometer, and the functional score Patient Related Wrist Evaluation (PRWE). Results: After a six week period of post-operative treatment, the patients performing a self-dependant home exercise program using a training diary reached significantly higher grip strength (83 % vs. 67 % of the starting base value; P = 0.0203). There were no differences in the range of motion of pronation/supination, extension and flexion, or ulnar and radial abduction. However, self training patients showed a significantly greater improvement of the functionality of the wrists according to PRWE score (8.4 vs. 22.5; P = 0.0029). Discussion: The effectiveness of a home exercise program requires motivated patients being self-responsible and independent in performing rehabilitation at home. The decision of treating patients self-responsibly has to be considered critically with the patient. Conclusions: In the rehabilitation of conservatively treated wrist fractures, good functional results can be reached using instructions in a home exercise program and are an effective alternative to prescribed rehabilitation treatment.
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