Treatment of intraarticular distal end radius fractures by ligamentotaxis: A prospective study

Abstract

Fractures of distal end radius are common fractures of the upper limb, and constitute 17% of all fractures and 75% of all forearm fractures 1. This fracture shows bimodal distribution of age with the fracture more commonly seen in children and elderly. The objectives of management for a distal end radius fracture should be restoration of range of motion and grip strength while facilitating the patient's early reinstation to normal daily activities and minimizing the chances of post traumatic arthritis. The treating orthopedician has an armada of treatment options to select from to accomplish this. Regardless of these fractures being common, there is no clear consensus on their treatment as there is no clear clinical-based evidence in the literature. For several decades, closed reduction and bridging external fixator for 4-6 weeks has been a well-established treatment of distal end radius fracture7. To reduce fracture fragments and maintain alignment, principle of ligamentotaxis is used by external fixation. This study aims to assess the functional outcome and duration for union in intraarticular distal radius fractures treated with external fixator using ligamentotaxis. The present study was carried out from 1ST December 2015 to 31ST January 2017 at Orthopaedic Department in Shri B. M. Patil Medical College Hospital and Research Center, Vijayapur. During this period 100 patients of intraarticular communited distal end radius fractures were treated surgically. We found 78% Excellent to Good results. 14 patients had Fair results while 8 patients had Poor results. Most common complication seen in our study were Pin Tract Infection (12%) and Restricted Wrist Motion (5%). It was concluded that external fixation offers good mode of treatment in communited fractures as they allow gradual distraction providing better functional and anatomical results in communited intraarticular wrist injuries.