Rigid internal fixation of displaced distal radius fractures.

Abstract

Distal radius fractures, the most common long bone fracture, are treated in several ways, including closed reduction, percutaneous pinning, external fixation, and open reduction and internal fixation. This article presents a surgical technique and a series of patients treated with a novel minimally invasive intramedullary fixation technique. The implant is a partially flexible intramedullary rod that can be locked in a rigid position once it is implanted in the bone. An awl and reamer are passed through a starter hole in the radial styloid using a 2-cm incision between the 1st and 2nd dorsal compartments. The device is then implanted under the articular surface, and the distal end of the curved implant is placed down the intramedullary canal of the radius. After locking the shaft segment rigidly, screws are placed through the implant under the distal radial articular margin to stabilize the fracture site. The sensory branches of the radial nerve are retracted during the case. Patients are treated in a wrist splint for a short period of time (2 to 4 weeks) depending on fracture type. The case examples demonstrate the minimally invasive nature of this procedure, the surgical technique, methods of fracture reduction and implantation, and surgical outcomes. Radiographic outcomes, postoperative motion, postoperative function, and validated outcome measures are demonstrated. This minimally invasive technique is ideally suited for distal radial fractures that do not involve the articular surface. It is a safe and effective technique that can provide excellent results.