External fixation of the wrist

Abstract

External fixation for fractures of the distal radius has been used for almost 80 years. The main objective is to gain reduction and maintain the reduction throughout the treatment period. Several fixator concepts are available and selection is based on the complexity of the case to be treated as well as the surgeon's experience. Periarticular application of the fixator with immediate use of the wrist joint is recommended whenever possible. In intra-articular fractures transarticular application is advisable. External fixation in complex fractures has to be supplemented by bone grafting, fixation wires and stabilization of the radioulnar joint. Associated injuries in distal radius fractures need to be identified and treated. The possible complications of external fixation are discussed and means to prevent them are referred to. External fixation of the distal radius has found its place as an established method in treating certain types of this common fracture.