Surgical outcome of intra-articular fractures of distal end of radius managed by external fixator - our experience

Abstract

Background & Objectives: Preservation of the articular congruity is the principle prerequisite for successful recovery following distal radius fractures. The best method of obtaining and maintaining an accurate restoration of articular anatomy however, remains a topic of considerable controversy. External fixation as a method of treatment for distal end of radius fracture has more than 60 yrs of documented clinical experience. The main aim of this study is to evaluate the results obtained by treatment of distal end radius fractures by external fixation.Methods: In a prospective controlled study, 30 cases of intra-articular fractures of distal end radius in adult patients were treated with uniplanar bridging type of external fixation using the principle of ligamentotaxis and augmentation by K wires. Mean age of the patients was 37.3years, External fixator was applied for a mean duration of 6 weeks and cases were followed up for an average of 37.0 weeks post operatively.Results: Assessed as per De merit point system of Gartland and Werley (modified by Sarmiento 1975) for functional results at the end of 6 months of follow up. Excellent to good functional result was noted in 83.3%.Conclusion: External fixation and ligamentotaxis provides better functional and anatomical results in intra-articular fractures of distal end radius. The success not only depends on the anatomical restoration of the articular surface. It also depends on the associated soft tissue injuries and articular damage.