Complications of treating distal radius fractures with external fixation: a community experience

Abstract

Objective: To analyze the immediate postoperative complications associated with treating distal radius fractures with external fixation.

Design: A retrospective chart review of data obtained from 24 consecutive patients who were treated with small AO external fixators in 1997.

Setting: Two community medical centers.

Intervention: Preoperative and postoperative radiograph measurements were taken of radial inclination, radial tilt, and radial length, and fractures were classified according to the AO system. Patient charts were reviewed to document demographics, type of fixator used, open or percutaneous technique for pin placement, use of augmentation, additional operations, and complications.

Main outcome measurements: Complications associated with treating distal radius fractures with one type of external fixator.

Results: Sixteen of the 24 patients had complications: 5 with neuropathies of the median or superficial radial nerve, 9 with pin track infections, 2 with pin loosening, one with a nonunion, 2 with malunion, and 4 patients each with radial shortening, loss of radial tilt, collapse of ulnar border or volar intercalated segment instability (VISI) of the lunate and rotatory subluxation of the scaphoid.

Conclusions: Postoperative complications following distal radius fractures treated with external fixation are common. Their effect, however, on long term functional results and patient satisfaction is negligible, with the exception of those patients with complications intrinsic to the fracture itself, i.e., nonunion, malunion or carpal malalignment.

Figure 1. AO Classification of the Distal Radial Fractures

Permission granted for reproduction of illustration.

Figure 2. Complications and Frequencies