Aims: 1. To assess the results and the effectiveness in the treatment of the complete articular fractures of the distal radius (23-C of MY̌ller), treated surgically with external þxation or osteosynthesis. 2. To support or refuse (conþrm or deny) the hypothesis that the treatment with external þxation is more efþcient, and less expensive, than the treatment with plate osteosynthesis. 3. To evaluate the effectiveness of the classiþcation of the fractures of long bones in segment 23. Material and Method: We study 733 fractures recorded in the AOI Documentation Center, 474 of which were treated with external þxation, while 259 were treated with osteosyn-thesis with plate. We study the variables of Sheets A (þliation) and C (follow-up) statistically. Results: From Sheet A we found statistic signiþcance differences in the age between sexes, but not between both treatments, local associated injuries (þxation > plate), associated treatment and reduction (þxation < plate), a better stability for the þxation, higher proportion of senior surgeon, general anaesthesia, antibiotic treatment and associated therapies for the plate group. In post-operative functional treatment, the external þxation group was better than the osteosynthesis. From Sheet C (follow-up), the group treated with osteosynthesis was far better than external þxation group in all of the variables. Conclusions: 1- The classiþcation of fractures of long bones, follows a gradient of increasing gravity. 2- The setting of the bone fracture was far better in the group treated with plate osteosynthesis, than in the group treated with external þxation, regardless of the group of fracture. 3- The þnal result is remarkably better in the group of plate osteosynthesis. 4- The ORIF with osteosynthesis has favoured a more frequent use of the bone grafting. 5- The þnal total cost of the treatment is much higher in the external þxation group. 6- We will use the external þxation in open fractures (open G-II-III), or with fragments not synthesing for theit size.

We studied the treatment with osteosynthesis in the 23-C fractures. Material and methods: we reviewed 259 complete articular fractures of the distal radius, type 23-C treated with plate osteosynthesis during 10 years. All cases are documented with the AOI sheets. All cases were classiþed with the Classiþcation of long bones of M.E.MŸller. Results: in the 259 fractures, 137 are females and 122 males, the age are between 10 to 84 years, the age average are 48ñ59 years (60ñ52 in females group, and 35ñ19 in the males group).

105 (41%) cases are in the right wrist, and 154 (59%) cases in the left wrist, 32 (12%) are open fractures. Etiology: 9% work,36% Trafþc,11% Sports,27% Home, 17% Others. The 17% had pathological antecedents previously. 18ñ5% had local injuries associated and 24ñ3% had general injuries associated. The 85% were operated for a Senior surgeon, 53% with loco-regional anaesthesia; 50% were treated with antithrombotic prophilaxis, and 26% with antibiotic treatment. 40% of cases needed some additional implant and the 24% needed surgery for the collateral injuries. We had 2% of acute local complications and 1% of general acute complications. During the follow-up, the 10% had local late complications and 1% had general late complications.

At the end of the follow-up, in 92% of patients (234 cases) use the extremity better than 75%, and 89% were pain free. X-Ray evaluation: 2% were Distrophy, and in 33% of cases had some articular alteration. Four months post-operative the 59% were recovered. The þnal disability is < 25% in the 85% of cases. Final evaluation: 88% of cases are good or excellent.

We studied the effectiveness of treatment with AO-Mini external þxator in complete articular fractures of distal radius, type 23-C. Mat. and meth.: we were reviued 474 distal radius complete articular fractures treated with AO-Mini external þxator during 10 years. All of fractures were documented by de AOI sheets. We used de Classiþcation of long bones from M.E.MŸller because itñs a global system of classiþcation. Results: in 474 fractures, 246 are females and 228 males. The age are between 15 to 94 years, and the age average 51ñ59 years (63ñ14 females, 38ñ84 males).212 fractures are located in the right wrist, and 262 in the left wrist. 14% (66 cases) were open fractures. Etiology: 19% Work,23% Trafþc,8% Sports,30% Home, 20% Others. The 15% of cases had pathological antecedents previously, 27% had local injuries associated and 28% had general injuries associated. 68% were operated for a Senior Surgeon, 61% with loco-regional anaesthesia, 33% were treated with antithrombotic prophilaxis, and 25% with antibiotic treatment. The 46% of cases needed some other implant, and 15% needed surgery for collateral injuries. Complications: 4% local acute complications and 1% of general acute complications. In the late follow-up, 18% of cases were local late complications and 2% general late complications.

At the end of the follow-up, in 81% of cases the use of extremity was better than 75%, and 83% of patients were pain free.

X-Ray: 10% had Distrophy, and 56% had some articular alterations.

Four month post-operative, 54% were recovered, and at the end of the follow-up 68%, of cases the þnal disability is < 25%. The final evaluation: is good/excellent in the 75% of cases.