Abstract
Purpose: To evaluate the effectiveness of external fixation in maintaining the reduction of the unstable distal radius fractures and to identify possible factors that might affect the loss of the reduction.
Material and Methods: Sixty-five unstable distal radius fractures were treated with the application of external fixation. Closed reduction was achieved in 45 (69%) fractures. Additional internal fixation (K- wires) was performed in 21(31%) fractures. The external fixator was removed at an average of 35 days. The dorsal, volar and radial displacement of the distal radius, and the radial height were recorded in anterior -posterior and lateral radiographs, immediately after the surgery and six months postoperatively.
Results: Loss of the reduction in, at least, one of the radiographic parameters was noted in 43(66%) fractures. The mean value of the dorsal displacement of the distal radius progressed from 2° immediately after the surgery to 5° at 6-month radiographs. Loss of the reduced volar tilt greater than 4° was measured in 32(49%) fractures. Radial height loss greater than 3 mm was recorded in 22(34%) fractures. Significant difference (p< 0.001) of the reduction loss was found when internal fixation accomplished by K- wires was added. However none corrective osteotomy for malunion of the fracture was needed to be performed. Age and the severity of the injury were not correlated with the final result.
Conclusions: External fixation in unstable distal radius fractures was found inadequate in maintaining the intra-operative reduction and should be augmented with internal fixation or with the use of bone grafts.
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.
