Treatment of Comminuted - Intraarticular Fracture of Distal Radius using External Fixator: Comparative Study of Treatment by External Fixation with or Without bone Graft

Ha, Snag Ho; Lee, Byoung Ho; Lee, Jun Young

Abstract

Distal radial fractures are recognized as very complex injuries with a variable prognosis that depends upon the fracture type and the treatment method. The purpose of this study is to compare radiological and clinical result between external fixation and external fixation with primary bone graft in intraarticular comminuted fracture of distal radius. From January 1993 to December 1995, 32 patients with comminuted intraarticular fractures of the distal radius were treated using a external fixation. 15 cases were treated with ligamentotaxis without bone graft and 17 cases were treated with additional primary bone graft. In last follow-up examination, the mean loss of radial length, radial inclination and volar tilt were less in with bone graft group than without bone graft group. According to Demerit point system Excellent to good results were obtained in 88.2% in cases of external fixation and bone graft group, 66.6% in cases of only extemal fixation group. External fixation combined with primary bone graft is more useful method for the reconstruction and treatment of comminuted intraarticular fractures of the distal radius than closed reduction and external fixation because cancellous bone graft not only provides early mechanical stability but also helps to reduce and supports the depressed intraarticular fragments. Furthermore, this method not only prevents late collapse of fracture but also enhance fracture healing.