Abstract
The external fixation device has successfully been applied in comminuted and unstable fractures of the distal end of the radius. We used the fixator in Smith type fractures, since they are unstable and the literature is quite poor.
Within 2 years, mean follow up time 13 months, we operated 21 patients (8 male, 13 female) aged 17–74 years (average 43 years) with Smith type fracture using Penning type external fixation device. The device remained for 6– 10 weeks (mean time of immobilization 8 weeks). early mobilization – dynamization was not applied to any of the cases.
The final estimation was based on the Gartland and Werley score system and the results were characterized as very good (83%), good (13%) and poor (4%). In those with very good result extension-flexion, supination –pronation of the wrist as well as the power grip were completelly rehabilitated (compared to the healthy limb) within 6 months. In those with good results the outcome was approximately the same to the previous group, involving though complications such as superficial infection, loosening of the pins, 1 case of mild algodystrophy, sensitivity disorders of the radial nerve. All complications were faded after the removal of the device.
Finally there was a case with lose of the reduction and malunion post the removal of the device, poor results due to the early (on the 3 week) mobilazation –dynamization of the wrist.
Despite the good clinical and radiological results, treatment of Smith type fracture with the use of external fixation does not provide earlier and complication free rehabilitation of the wrist, so that should be used in certain cases only.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
