Radio-radial external fixation in the treatment of distal radius fractures allows for free wrist motion

INTRODUCTION: Joint bridging external fixation in the treatment of distal radius fractures restores radial length, whereas anatomic reduction of articular fragments is difficult. Immobilisation of the wrist joint is a further disadvantage. An extraarticular hybrid fixation of distal radius fractures was introduced that facilitates fracture reduction, safe retention and allows for free wrist movement. METHODS: 30 consecutive patients with extra- and intraarticular comminuted fractures of the distal radius were treated with an extraarticular radio-radial external fixation employing a modified Ilizarov hybrid fixation technique. The operative procedure is described in detail. A clinical and radiological evaluation was carried out on the first and seventh day as well as 6 weeks postoperatively after implant removal. RESULTS: Anatomic reduction was achieved in 24 cases (80%). On the first postoperative day dorsiflexion was 30%, palmar flexion was 51% and pronation/supination was 60%/70% of the uninjured side. Six weeks postoperatively all fractures united. Wrist motion of the affected side was more than 80% of the unaffected side. Neither extensor tendinitis nor pin loosening in the distal fragment did occur. CONCLUSION: The technique of extraarticular hybrid fixation is safe and reliable in the treatment of comminuted fractures of the distal radius. It allows for early wrist movement in the immediate postoperative period.