Role of external fixator combined with t-plate internal fixation in the treatment of comminuted distal radial fractures

RESUMO

Background: A technique of external fixator combined with T-plate internal fixation for intra-articular fractures of the distal radius is based on the finding that the separate t-plate fixation do not give complete stability to the fracture. However, if it is combined externally by external fixator, you get a solid synthesis of the fractured radius. This enables early mobilization of the wrist without the use of plaster cast. Objective: The aim of the study was to evaluate the results of external fixator combined with palmar T-plate internal fixation for the treatment of comminuted distal radial fractures. Patients and methods: This was a prospective study that was conducted on 20 patients. Patients were treated by the external fixator combined with T-plate internal fixation. All patients were attending to the Emergency Department and Outpatient Clinic of Orthopedic Surgery Department in Tanta University Hospitals. Results: Patients had excellent range of motion, normal ROM of the arm, shoulder and hand. No significant differences in the radiographic parameters were detected between fracture fixation and fracture healing. Complications were few. At final follow-up evaluations, patients had well to excellent results with respect to range of motion scores. Stable fixation allowed starting active and passive motion of the wrist without compromising postoperative alignment. The poor results in this case were due to late intervention, osteoporosis due to old age and poor general condition of the patient, which resulted in incomplete union. Conclusion: External fixator combined with T-plate internal fixation is an efficacious treatment option for intra-articular distal radius fractures with excellent long-term results: