Early hybrid nonbridging external fixation of unstable distal radius fractures in patients aged ≥50 years

Abstract

Objective We evaluated hybrid nonbridging external fixation (NBEF) supplemented by K-wires as an effective and safe treatment option for osteoporotic distal radius fractures (DRFs) in a retrospective case series. Methods Sixteen extra-articular and one intra-articular DRF were treated by NBEF from 2016 to 2018 (mean patient age, 61.8 years; 15 women, 1 man). Radiographic parameters (volar tilt, radial inclination, and ulnar variance), range of motion, grip power, the visual analog scale score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed at 4 weeks, 6 weeks, 6 months, and 12 months postoperatively. Results The volar tilt and radial inclination were restored after surgery and maintained well. The mean visual analog scale score was 4 ± 1 at 4 weeks. Range of motion was restored to 79% to 91% at 6 weeks. The DASH score was good before NBEF device removal. Two superficial pin-tract infections were easily treated with antibiotics. Conclusions Hybrid NBEF transfixes DRFs in a multiplanar fashion, and augmentation with percutaneous K-wires provides direct fixation in radial shift and withstands axial loads in fracture fragments. It allows early mobilization with rigid fixation. Hybrid NBEF is reliable for unstable extra-articular and simple intra-articular DRFs in older patients. Clinical Study registration number ChiCTR1900021712

Effects and Anti-rotation Stabilization of the Non-bridging External Fixation for Pronation-Abduction Stage III Ankle Fracture: A Cadaveric Study

“…Moreover, the nonbridging external fixation had been commonly used for distal radius fractures, although it could improve early motion with nonbridging construction. The function outcomes were similar to the external bridging fixation [ 23 ]. There were few studies about nonbridging external fixation for the ankle [ 24 ].…”

Treatment of Distal Radius Fractures with Bridging External Fixator with Optional Percutaneous K-Wires: What Are the Right Indications for Patient Age, Gender, Dominant Limb and Injury Pattern?

“…To date, only a few studies have focused on the role of additional KWs in EF [12]. Among the 269 cases included in our study, 75 (28%) were treated by associating percutaneous synthesis with KWs to the BEF.…”

“…Nevertheless, to the best of our knowledge, this is the first single-centre study reporting functional clinical outcomes of DRFs at medium-term follow-up and including beta multivariate regression analysis on a large patient cohort compared to previous published studies on the same topic [12,46,[68][69][70]. Further, all patients enrolled were operated on by the same trauma surgeons and followed according to a standardised institutional postoperative protocol, reducing confounding bias.…”

“…The external fixator devices and the optional KWs were removed four to five weeks from surgery as an outpatient procedure after radiographic control. The exact timing varied depending on the pin site stability and radiographic evidence of bone fusion or temporary callus bone bridging formation [12,29].…”

“…Active and passive mobilisation was started immediately; resistance activity was granted starting one week after the removal of the fixator. The daily and work activities were gradually resumed, reaching the absence of limitations twelve weeks after the surgery [12] (Figures 4 and 5).…”