Long-term results of the external fixation of distal radius fractures.
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.
- [Show abstract] [Hide abstract]
ABSTRACT: The aim of this study is to compare the radiological and functional outcomes of open reduction and volar locking plates versus external fixation (EF) in the treatment of unstable intra-articular distal radius fractures. In this retrospective comparative study, 69 of 80 patients who underwent an operation for AO/ASIF C1, C2 and C3 distal radius fractures were assessed. Functional evaluation was performed using the Gartland-Werley scoring system and the PRWE scale, and wrist range of motion and grip strength was also measured. For the radiological assessment, radial inclination, volar tilt, radial length, ulnar variance, and articular step-off were compared. The range of movement was better for all parameters in the volar plate group, but only wrist flexion and pronation range differed significantly between the groups (p = 0.037 and p = 0.014, respectively). With the exception of better subjective functional results in the volar plate group, the differences were not significant. With respect to radiological evaluation, all parameters were better in the volar plate group, but only radial inclination and articular step-off were significantly better (p = 0.018 and p = 0.029, respectively). In the volar plate group, two patients had carpal tunnel syndrome and one patient had regional pain syndrome. In the external fixator group, six patients had superficial pin tract infection, two patients had sensory branch injury, and four patients had regional pain syndrome. Volar locking plate fixation appeared as a dependable method for the treatment of intra-articular distal radius, with lower complication rates. On the other hand, EF remains a suitable surgical alternative for these fractures, with easy application and acceptable results.European Journal of Orthopaedic Surgery & Traumatology 02/2013; · 0.18 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The biomechanical stability of an internal fixation system that uses low-profile modular implants to stabilize individual fracture components was studied in a validated cadaver fracture model that incorporated physiologic muscle forces and wrist motion. Fragment-specific fixation with immediate range of motion was compared with static augmented external fixation in simulated, unstable 3- and 4-part intra-articular distal radius fractures (n = 20). Fixation was applied and specimens were loaded via their major wrist tendons. Because the wrist joint was not constrained in the internal fixation group, full wrist motion occurred during load application in these specimens. A 3-dimensional motion tracking system calculated individual fracture fragment motion in both groups. In the 3-part fracture pattern fragment-specific fixation showed comparable stability to static augmented external fixation despite the full wrist range of motion that occurred during application of load in these specimens. In the 4-part fracture pattern fragment-specific fixation was shown to be significantly more stable when compared with static augmented external fixation in 4 of 6 axes of motion. Our findings confirm the stability of this low-profile plating system and support the consideration of early wrist motion when treating complex, intra-articular distal radius fractures with fragment-specific fixation.The Journal Of Hand Surgery 12/2002; 27(6):953-64. · 1.57 Impact Factor
- The Journal Of Hand Surgery 08/2000; 25(4):776-7. · 1.57 Impact Factor