Transarticular fixation with external fixators in unstable distal radius fractures / 中华创伤骨科杂志

ABSTRACT

Objective To retrospectively analyze the results of closed reduction and static trans-articular fixation with unilateral external fixators in the treatment of unstable distal radius fractures.Methods From June 2000 to March 2005,45 patients with 50 unstable distal radius fractures were treated with closed reduction and static transarticular fixation by unilateral external fixators.Their average age was 44.8 years(15 to 78 years).All the fractures were classified with AO-scheme.There were five A3-fractures,four B3-fractures,three C1-fractures,nine C2-fractures and 29 C3-fractures in 24 cases.Follow-ups lasted from 8 to 48 months(averaging 20 months).Results The time of bone healing was 6 to 8 weeks(averaging 7.6 weeks).At the latest follow-up,the radiological outcomes were excellent in 42 fractures(39 patients)and good in eight fractures(six patients)according to the Sarmiento rating system modified by Ste wart et al.The functional results included 37 excellent cases(34 patients),nine good ones(eight patients)and four fair ones(three patients)according to the Gartland-Werley assessment.There were only four cases of superficial pin site infection settled with oral antibiotics and mild disinfectants.Conclusions Closed reduction by manipulation and static transarticular fixation with unilateral external fixators is an effective method to treat severely comminuted distal radius fractures caused by high-energy injury.Radial nerve injury and iatrogenic fracture of the 2nd metacarpal bone can be avoided,pin tract infection and pin loosening can be decreased,and early postoperative mobilization of hand can be facilitated by insertion of external pins at appropriate sites.It is unnecessary to apply supplementary bone grafting to promote bone healing.