Dynamic external fixation of distal radius fractures.

Abstract

External fixation in fractures of the distal radius has been used for almost 80 years. The main objective is to achieve reduction and maintain the reduction throughout treatment. The fixator concept described as the dynamic fixator allows reduction in three planes and allows for the wrist to move after a period of rigid fixation. Fixator application is illustrated for fractures that necessitate bridging of the wrist joint and for extra-articular fractures. Indications for additional measures, including bone grafting, k-wire fixation, and stabilization of the radioulnar joint, are discussed. Associated injuries and postoperative management is described. The technique of correcting malunited fractures with the assistance of an external fixator is explained, with special emphasis on the correction of radial length, angle, and shift. The results of initial trials show a low complication rate and indicate that bone grafting should probably be used more than previously recommended.