Long-Term Results of the External Fixation of Distal Radius Fractures

Rikli, Daniel; Küpfer, K.; Bodoky, A

doi:10.1097/00005373-199806000-00007

Cited by 48 publications

(30 citation statements)

References 14 publications

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“…On comparison of anatomical results with functional results it was found that anatomical results were satisfactory in 83.33% and functional results were satisfactory in 86.66%. Our results supports the hypothesis by many authors that ultimate functional results after fractures of the distal radius correlate directly with restoration of normal anatomy [2,12,20,21] .…”

Section: Discussionsupporting

confidence: 92%

“…The complication rate in our series is 30%. It is similar to the reported range of 32-34% in the literature [20,21] , but higher than the studies of others [8,22] which reported a rate ranging from 4-17%. The higher rate in our series compared to these series were due to the fact that we didn't use limited open surgical technique (open placement of pins) in the initial cases.…”

Section: Discussionsupporting

confidence: 90%

“…These fractures are treated by open reduction [3,11,19] . The Volar barton type of intraarticular fractures are also not well reduced and maintained by external fixation resulting in articular step-off, are better treated by Volar Buttress plate [20] . All the three patients developed radiographic OA (Grade II-1 Grade III-2) and two had clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

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

Channareddy¹

2018

Int. J. Orthop. Sci.

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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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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

Channareddy¹

2018

Int. J. Orthop. Sci.

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“…The initial treatment of the wrist fractures consisted of closed reduction and external fixation (AO-ASIF mini external fixator, Stratec Medical, Oberdorf, Switzerland) in a standardized technique using manual traction [16]. The procedure was carried out within 24 h of the accident.…”

Section: Methodsmentioning

confidence: 99%

Complex Fractures of the Distal Radius

Rikli

Rosenkranz

Regazzoni

2003

European Journal of Trauma

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Objective: Outcome of complex distal radius fractures. Design: Retrospective clinical observation. Setting: Outcome assessment of a clinical series of patients with complex distal radius fractures treated according to a structured, stepwise treatment algorithm. Patients: 17 patients (average age 47 years) with mostly high-energy injuries, 16/17 articular fractures including concomitant carpal injuries, fracture dislocations, extension of the fracture into the diaphysis, and large defects.Intervention: Initial external fixation, followed by soft tissue treatment and further diagnostics and, finally, definitive adapted surgical therapy including combination of external fixation, plates, screws, K-wires, bone graft, and ligament repair. Main Outcome Measurements: DASH, range of motion, radiologic outcome. Results: Average subjective overall performance score (DASH) 16.4 (0-36.7, standard deviation [SD] 11.82, 95% confidence interval [CI] 8.0-23.6), 73% of the patients back to premorbid work and activities. Conclusions: Using a clearly structured, stepwise approach, complex distal radius fractures can be treated with good clinical outcome preserving hand function.

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“…Restoration of radial length, radial tilt angle and congruity of articular surfaces is important for good functional results [3] . There is evidence to suggest that anatomical articular reduction greatly reduce the incidence of post traumatic Osteoarthritis [4] .…”

Section: Lateral Viewmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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Aim: Distal radius fracture is common fracture in daily orthopaedic practice accounting for 1/6 th of all the fractures. Conventionally the fractures were treated with closed reduction and immobilization with casts. Even though union of these fractures occurs, they have a very high incidence of going in for malunion and wrist joint instability especially with comminution & intra articular extension cases. Moreover a change in trend to younger age groups as a result of RTA's (road traffic accidents) & trauma is leading to more complicated fractures with intraarticular extension and comminution. Also the importance of anatomical alignment and reconstruction of radiocarpal and radioulnar ulnar joints has been emphasized in recent trends. Hence the management of distal radius fractures changed from universal use of cast immobilisation to operative interventions. Aim of this study is to observe the effect of external fixation for unstable distal radius fractures in rural set up. Materials and methods: Prospective analysis of 30 patients with unstable distal radius fractures, who were operated at MIMS hospital, nellimarla village, vizianagaram district between may 2016 to feb 2017 treated with external fixator. Patient position-supine with arm table support. For external fixation of the wrist we used the 4 mm (small) external fixator system. For pin insertion into the second metacarpal, the distal pin is inserted proximal to the transition of the metacarpal head into the shaft and the more proximal pin is inserted distal to transition of the shaft into the metacarpal base.The proximal two pins are inserted proximal to the muscle bellies of abductor pollicis longus (APL) and extensor pollicis brevis (EPB). Proximal to these muscles, the radial shaft is palpated through the skin between the bellies of the extensor digitorum communis (EDC) and extensor carpi radialis longus/brevis (ECRL/ ECRB) over a distance of 3-4 cm at which the proximal pins inserted into the radial shaft with 4-5cms apart. Longitudinal traction is applied on the thumb and index finger or the distal partial frame to reduce the fracture. T clamps are fixed to bridging rods, first proximally followed by tightening of distal fragment T clamps to maintain the traction and reduction, there by healing of fracture by the principle of ligamentotaxis. Results: Average Mean hospital stay is 4days, there are 13males and 17 females between age group 28-60yrs, 27 cases out of 30 had functional and radiological union by 12weeks (range 6-18 weeks), 2 had pin track infection which were treated successfully with iv antibiotics. 1 patient had deep bone infection and pin loosening which was managed with external fixator removal, long course antibiotics and casing. We followed standard Sarmiento radiological scoring system, Gartland and Werley Score (demerit system) demerit point scoring system, DASH scores, Green & O Brien grade scoring systems to evaluate the end results. Conclusion: External fixation of unstable distal radius fractures can be considered as ef...

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Long-Term Results of the External Fixation of Distal Radius Fractures

Abstract: The external fixator is a versatile tool in the treatment of intra-articular and extra-articular fractures of the distal radius. The rate of algodystrophy (reflex sympathetic dystrophy) was 6%, and wrist stiffness was not found in our series.

Cited by 48 publications

References 14 publications

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

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

Complex Fractures of the Distal Radius

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