Combined fixation for comminuted intra-articular fracture in distal radius / 中国矫形外科杂志

ABSTRACT

[Objective]To explore the effective treatment method of the articular fracture in distal radius.[Method]Severely comminuted AO type-C3 intra-articular fractures of the distal end of the radius were treated with combined internal and external fixation.The Gartland and Werley system and the Green and O'Brien system were used for comparison of the pre-operative and after operative evaluation.Total articular congruity had been assessed with both clinical rating systems.[Result]At a mean of ninteen months following-up,the mean arc of flexion-extension was 78% of that on the uninjured side and the mean grip strength was 82% of that on the uninjured side.The mean total articular incongruity(the gap plus the step-off)averaged 2 mm,and the radial length was restored to a mean of 11 mm.According to the Gartland and Werley demerit-point system,seventeen of the patients had a good or excellent result.According to the modified Green and O'Brien clinical rating system,eleven had a good or excellent result.Postoperative total articular incongruity had a moderately strong correlation with the outcome as assessed with both clinical rating systems.[Conclusion]Open reduction and combined internal and external fixation of AO type-C3 fractures can restore radiographic parameters to nearly normal values,maintain reduction throughout the period of fracture-healing,and provide satisfactory functional results.