Abstract
Aim: To demonstrate that external þxation cannot be used alone to treat unstable distal radial fractures associated with a combination of dorsal and volar comminution. Methods: 17 patients with a mean age of 47.5 years, sustaining Frykman grades VII and VIII fractures of the distal radius associated with high energy trauma between 1996 and 1998, treated solely with external þxation were assessed. The mean time to operation was 3.4 days. The mean time to review was 15.8 months. There was dorsal comminution in 7 patients with additional volar comminution in 10 cases. Results: Excellent functional outcome results were obtained with a mean mass grip strength of 79.6%. However, when comparing patients with a combination of dorsal and volar comminution with those sustaining dorsal comminution alone, loss of radiographic parameters resulted in the former at review. Post-operative and review mean volar tilt values were + 1.5¡ and Ð 3.6¡ respectively cf. + 2.3¡ and 6.6¡, whilst the mean post-operative and review radial length values were 13.9 mm and 10.7 mm respectively cf. 11.6 mm and 11.4 mm. Comparison of the two groups for volar tilt and radial length gave P values of 0.004 and 0.02. Conclusion: External þxation is not an effective sole modality of treatment in cases associated with both dorsal and volar comminution. It is also highly recommended that when considering the use of external þxation, the degree and type of comminution is appreciated on the pre-operative radiographs.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
