Treatment of the Distal Radius Intra-articular Fractures with External Fixator

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Journal of the Korean Society for Surgery of the Hand 1999;4(1):42-50.
Published online January 1, 1999.

Duke Whan Chung,Chung Soo Han,Myung Ho Jun,Jae Hoon Lee

외고정 기구를 이용한 요골 원위부 관절내 골절의 치료

정덕환,한정수,전명호,이재훈

Abstract

Although fractures of the distal radius are common, an optimal treatment method has not been delineated, especially in unstable fractures. Therefore, fveafing unstable and comminuted intraarticular fractures of the distal part of the radius remain a challenging problem. Over the past few years, the importance of alignment correction, preservation of normal radial length, and reconstruction of congruity of both the radiocarpal and radioulnar joints have been emphasized. Open reduction and rigid internal fixation seem to be appropriate for less comminuted, displaced, and irreducible intraarticular fractures. Treatments of choice for more severely comminuted fractures are the incorporation of transfixing K-wire within the plaster and the use of external fixation. We reviewed 32 cases of unstable intraarticular fractures of the distal radius treated with external fixator to improve anatomical and functional result. The average follow up period was 3 years and 11 months(from 2 years to 6 years 2 months). The average bone union timewas 12 weeks(range, 11-16 weeks). In conclusion, the deleterious effects of prolonged immobilization on intra-articular cartilage and the surrounding soft tissue structures have been well documented both clinically and experimentally. For these reasons, we believe the optimal treatment for complex distal radius fractures includes external fixation, to faciliatate reduction and in some cases to protect the reduction against the forces of shortening; internal fixation, to accurately restore the anatomy and allow early removal of the external fixator; and early mobilization of all joints in the hand and wrist.

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