[Less invasive leverage reduction with external fixator supported and bone graft for treatment of unstable fractures of distal radius]

Abstract

Objective: To assess the results of treatment of unstable distal radius fractures with leverage reduction and bone graft assisted by external fixators.

Methods: From September 2005 to May 2007, 27 cases of unstable distal radius fractures were treated by leverage reduction and bone graft, meanwhile assisted by external fixators. The cases included 16 males and 11 females, aged from 18 to 69 years with an average of 49.3 years. Fractures were caused by falling in 19 cases, crash from high place in 1 case, traffic accident in 6 cases, and obtuse strike directly in 1 case, which were all closed fresh bone fractures. According to the standard of AO, all cases were classified as type C1 in 13 cases, type C2 in 11 cases, and type C3 in 3 cases. The palmar inclinination was from -38 degrees to 10 degrees (mean -12.2 degrees); the ulnar deviation angle was from 6 degrees to 30 degrees (mean 19.1 degrees) before operations. The operations were performed from 1 to 3 days after injuries. The function of the carpal joints and the bone healing conditions were evaluated after operations.

Results: All cases were followed up for 4-24 months (mean 13.1 months). No complications such as pin loosening dislocation of fixators, injury of blood vessels and radial nerves, pin track infections occurred. According to Mcbride scoring, the results were excellent in 10 cases, good in 13 cases, fair in 3 cases and poor in 1 case, the excellent and good rate being 85.2%. One case had traumatic arthritis and 1 case had wrist joint stiffness. All achieved fractures uniton 8-10 weeks (mean 9.3 weeks) after operations. The palmar inclinination angle was from 0 degree to 20 degrees (mean 13.40 degrees); the ulnar deviation angle was from 10 degrees to 33 degrees (mean 22.1 degrees) after operations.

Conclusion: Treatment of unstable fractures of the distal radius by use of leverage reduction and bone graft with external fixator offers many advantages, such as simple operation, satisfactory reduction, rigid fixation, excellent function and lower incidence rate of traumatic arthritis.