Evaluation of results of comminuted intra-articular fractures of the distal end of the Radius treated by external fixation

Abstract

Thirty patients with comminuted intra-atricular fractures of the distal end radius, less than 65 years old (mean age 38 years) have been treated by external fixation. Fractures were classified according to Frykman's Classification. Radiological results were assessed using stewart's criteria. Functional results were evaluated with Demerit point system of Gartland and werly as modified by Sarmiento. It improves extra-articular alignment (radial angle, radial length and Volar tilt). The articular surface was restored to normal congruity or to within 1mm step-off in 23 patients. Only three patients had step-off more than 2 mm. The most common complications were pintract infections in three patients and radial nerve neuritis in two cases. At mean follow-up of twenty-five months anatomical results and functional results were good to excellent in 83.33%(n=25) and 86.66%(n=26) respectively. Anatomical results correlated with functional results. Results suggest that the external fixation gives better anatomical and functional results and remains a viable surgical alternative for management of comminuted intra-articular displaced distal radius fracture.