Augmented external fixator for treatment of unstable lower radius fractures

ABSTRACT

Unstable distal radius fractures are those with severe displacement, comminution or intra-articular involvement. Treatment of unstable fractures with cast immobilization only is not adequate and resulted in more than 30% incidence of complications. The use of external fixator for treatment of these fractures has improved markedly the results of treatment. But it was found that treatment with external fixator alone did not always accomplish reduction of all articular fragments of a complex intra-articular fracture. Also excessive distraction and long period of immobilization [6-8 weeks] may cause stiffness and disuse atrophy [osteopenia of the carpus and distal radius] and increased incidence of pin tract infection. The combination of the external fixator, pinning of the key articular fragments and/or grafting of the dorsal defect through limited exposure has further improved the results and allow early removal of the fixator and restoration of wrist movements. In this paper, the details of treatment of 30 cases of unstable distal radius fractures treated by this method are presented. Ninety percent excellent or good functional and anatomical results were obtained at the end of follow-up period [minimum one year]