Surgical treatment using external fixator for unstable intra-articular fracture of distal radius

Kim, Chul Hong; Kim, Byeong Hwan; Lee, Sung Won; Kim, Wook

Abstract

PURPOSE: To analyze the results of surgical treatment using external fixator for unstable intra-articular fracture of distal radius. MATERIAL AND METHODS: We investigated 38 cases of distal radius fracture from Mar. 1990 to Dec. 2000. The patients were followed up for average 18 months postoperatively. We compared the results of 22 cases, treated with open reduction and internal fixation(ORIF) to the results of 16 cases, treated with ORIF and external fixation. We evaluated the results of the mean loss of radial length, radial inclination, volar tilt and traumatic arthritis according to demerit point rating system above the Fernandez classification IV.
RESULTS
According to demerit point rating system, excellent to good results were obtained in 72.7% at ORIF and external fixator, compared to 43.8% at case of ORIF only. In the last follow up, the mean loss of radial length was 0.6mm in case of ORIF, but 0.4 mm in case of ORIF and external fixator, the mean loss of radial inclination was 2.3 and 1.5 degrees, the mean loss of volar tilt was 2.5 and 2.2 degrees, respectively (p < 0.05). Postoperative complications were developed in 9 cases. Malunion was in 4 cases of ORIF and external fixator, in 2 cases of ORIF. Metacarpal bone fracture was in 1 case of ORIF and external fixation. Traumatic arthritis was in 2 cases of ORIF.
CONCLUSION
Open reduction and internal fixation combined with external fixation was thought to be a better method than open reduction and internal fixation for the treatment of unstable intra-articular fractures of the distal radius of the Fernandez classification IV and IV, because that was more comfortable and convenient to patients and was useful to prevent late displacement.