External Fixation of the Unstable Distal Radius Fracture -According to the AO classification-

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Journal of the Korean Society for Surgery of the Hand 1997;2(2):227-238.
Published online January 1, 1997.

Jun Mo Lee,Kwang Bok Lee

불안정성 요골 원위부 골절에서 시행한 외고정술 AO 분류를 중심으로

이준모,이광복

Abstract

Articular fracture of the distal radius requires an accurate anatomic reduction as minimal step-offs are associated with the development of osteoarthritis. The intraarticular unstable fractures of the distal radius have been treated to maintain the intraarticulat congruence, start early rehabilitation and lessen the postoperative complications by percutaneous K-wires fixation, external fixation and autogenous iliac cancellous bone grafting. Percutaneous K-wires fixation after open reduction minimizes additional soft tissue dissection and external fixation with strategic pin placement gives enough rigid fixation to tolerate the early wrist motion and the autogenous bone grafting enhanes fracture healing. There were 14 cases of intraarticular unstable Colies' fractures classified by AO classification and treated by percuteneous K-wires fixation, external fixatian and iliac cancellous bone grafting and we have followed up from June 1992 through March 1997 at Department of Orthopedic Surgery, Chonbuk National University haspital. The final resuts were as follows. 1. The autobike traffic accident were 6 cases, in-car accident4 cases, out car and slip were 2 cases each. Analysis of the original roentgenograms revealed that C3 were 8 cases, C2 4 and C1 2 cases according to the AO classification. 2, Roentgenograms showed near-normal three wrist views except 3.3 degrees palmar tilt. 3. Wrist motion regained 55.7 degrees in supination(normal 80 degrees), 66.4 degrees in pronation(normal 80 degrees), 35 degrees in palmar flexion(normal 65 degrees), 20.7 degrees in dorsiflexion(normal 85 degrees). 4. Overall evaluation by Gartlands criteria, 4 cases were excellent, 6 good, and 4 cases sustainted with high-energy injury were fair. 5. Postoperatively sensory decrease of the median nerve was encountered in 1 C1 open fracture and observed for 8 months for full recovery.

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