A clinical study of management of comminuted distal radial fracture in adults by external fixation and ligamentotaxis

Abstract

Background: The primary goals of distal radius fracture fixation are to put the pieces back where they belong and, most importantly, to do so by a method that does not compromise hand function. Displaced comminuted intra-articular fractures of the distal radius are difficult to treat; successfully by traditional non-operative methods. Thus, external fixation plays a very distinct role. Materials and methods: Twenty adult patients with closed comminuted intra- articular fractures of the distal radius were treated by closed reduction and immobilization with an external wrist fixator during period from Dec 2018 to Nov 2019. Six weeks later, the fixator was removed. The patients then were observed for an average of 6 months to 1year. Result: An excellent outcome was seen in 3 patients (15%) good outcome in 11 patients (55%) and a fair outcome in 5 patients (25%) and poor outcome in 1 patient (5%). Minor complication, pin tenderness were present but recovered completely after removal of the fixator. Conclusion: External fixator is simple and inexpensive. Displaced severely comminuted intra-articular fractures should be treated with an external fixator. It effectively stabilizes fractures yet allowing for hand and prevents stiffness. It is difficult to regain volar tilt by ligamentotaxis and maintain it by external fixators. Most complications are minor and easily treated and do not affect Outcome. The ease of use of the implants and successful track record make it an extremely versatile tool for treating complex fractures of the distal radius.