Severely comminuted distal radial fracture as an unsolved problem: Complications associated with external fixation and pins and plaster techniques

Weber, Stephen C.; Szabo, Robert M.

doi:10.1016/s0363-5023(86)80045-4

Cited by 178 publications

(69 citation statements)

References 43 publications

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“…The method of joint distraction for treating comminutive intra-articular fractures dates back to Böhler in 1929 [5,6]. A decade later, Anderson and O'Neil propagated the use of the external fixator [7,8], which is also a currently frequently used treatment tool [9].…”

Section: Introductionmentioning

confidence: 99%

“…It is appreciated for its easy application but has the disadvantage of a non-neglectable complication rates [10][11][12][13][14][15]. Pin-tract infections occur in up to 23% of the patients, and fractures at the pin-entry site have been reported along with aesthetic issues and inconvenience to dress [6,16]. A further problem is the reduction of small fracture fragments without ligament attachments.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of highly comminuted distal radius fractures with temporary distraction plate

Bouvet¹,

Steiger²,

Smet³

et al. 2017

Hand Microsurg

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Surgical treatment of highly comminuted distal radius fractures in elderly patients with poor bone quality or in polytrauma patients is a technical challenge. Aim: The aim of this study was to evaluate the results of temporary bridge plating in these patients. Method: A retrospective review using data from 21 patients undergoing temporary bridge plating in our department was performed. All patients had fractures classified as type C3 by AO classification. To achieve optimal joint surface reduction, supplementary fixation was necessary in all cases. Data was evaluated for clinical and radiological parameters. Results: Radiological results showed a mean post-operative positive ulnar variance of 1.2 mm, mean radial inclination of 18° and a mean radial length of 10 mm. Furthermore, correlations between fracture patterns and ligament injuries were analyzed. Conclusion: Temporary bridge plating is indicated in the treatment of highly comminuted distal radius fractures in elderly patients with poor bone quality and young polytrauma patients. (Level of evidence: Level 4)

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of highly comminuted distal radius fractures with temporary distraction plate

Bouvet¹,

Steiger²,

Smet³

et al. 2017

Hand Microsurg

View full text Add to dashboard Cite

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“…3 However other authors have reported satisfactory outcomes following EF for unstable DRFs although few authors have reported complications related to over distraction of articular injuries, including severe digital stiffness, reflex sympathetic dystrophy, and nerve dysfunction in cases managed with Ex-fix. [4][5][6] For IF, dorsal plating and fragment specific fixation techniques are less frequently performed. Many authors have reported excellent outcomes following IF with volar plating for unstable DRFs.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes in management of unstable distal radius fractures treated with external fixation and internal fixation: a prospective comparative study

et al. 2017

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Background: Management of Distal Radius fracture that are inherently unstable is still a matter of debate. There is no conclusive evidence that support one surgical fixation method over another. An attempt was made to analyze patients treated with Ex-Fix and Internal-Fixation for unstable distal radius fractures and evaluate the clinical efficacy of Ex-fix using principles of ligamentotaxis and Internal-fixation and compare functional recovery, fracture healing time and complications.Methods: A prospective trial was undertaken at our hospital with 35 patients,all aged >20 yrs with closed distal radius fracture and divided into two groups: group I (Ex-fix with or without percutaneous k-wire, and JESS) and group II (Int-Fixation) including 14 and 21 patients, respectively. Periodic clinical examination and x-ray review was carried out to find out fracture union, and functional assessment. Patients were followed up for 1 year, 6 months average.Results: Group I consumed significant less operative time, fluoroscopic exposure, reduced hospital stay, quicker post-operative pain relief. Quick DASH score were significantly high in elderly treated with Ex-Fix in comparison to young in which DASH score was higher with internal-fixator. Functional recovery was early with int-fixation but post-operative wrist stiffness was also higher. 2 cases of delayed wound healing &1 case of pin tract infection with ex-fix application was observed. Conclusions: Internal-fixation remains the treatment of choice for unstable distal radius fracture involving the articular surface and in the young, while ext-fixation can be considered as a primary treatment modality in the extra-articular fractures in young or even intra-articular fractures in the elderly.

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“…The standard treatment of this fracture still remains controversial [1][2][3][4][5][6][7][8] . Specific problems in term of stability and immobilization due to combination of dorsal cortex and the intra-articular involvement itself are encounter [2][3][4][5][6][7][8][9][10][11][12][13] . There are many treatment options like closed reduction, casting, cast-immobilization, external fixation with or without percutaneous pin and open reduction internal fixation with plate screws and intramedullary devices.…”

Section: Introductionmentioning

confidence: 99%

“…Roger Anderson device is the early external fixation device used to treat distal radius fractures. Many authors recommended external fixation for intraarticular comminuted distal radius fractures although it has high complication rate and these are pin related [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . For intra-articular fractures restoration of articular congruity seems to be more important and critical than restoration of radial length and reduction of dorsal tilt of articular surface radius 18 .…”

Section: Introductionmentioning

confidence: 99%

Treatment of Comminuted Intra-articular Fractures of Distal Radius by External Fixator

et al. 2014

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Background: Treatment of comminuted intra-articular fractures of distal radius by external fixator is an important. Objective: The aim of study was to investigate the usefulness of external fixator as a treatment option for displaced comminuted intra-articular fractures of distal radius. Methodology: This case series was conducted in the Department of orthopaedic Surgery at Shaheed Suhrawardy Medical College& Hospital, Dhaka during the period of November 2011 to July 2013. All the patients having comminuted intra-articular distal radial fractures were being treated with mini uniaxial external fixator under brachial plexus block. The average follow up was performed in about 6 month. Result: A total number of fifteen patients were enrolled for this study. The mean age with SD was 50.21±9.473. Patient outcomes were measured by modified Knirk and Jupiter score and were categorized as satisfactory and unsatisfactory groups. In this study satisfactory outcome was found in 86.0%. All fractures (100.0%) were united nicely. Few complications were encountered. Postoperative osteoarthritis was not found during follow up. Conclusion: The use of external fixator for treating the comminuted intra-articular distal radial fractures produces satisfactory result.

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Severely comminuted distal radial fracture as an unsolved problem: Complications associated with external fixation and pins and plaster techniques

Cited by 178 publications

References 43 publications

Treatment of highly comminuted distal radius fractures with temporary distraction plate

Treatment of highly comminuted distal radius fractures with temporary distraction plate

Clinical outcomes in management of unstable distal radius fractures treated with external fixation and internal fixation: a prospective comparative study

Treatment of Comminuted Intra-articular Fractures of Distal Radius by External Fixator

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