[Treatment of complicated fracture of the distal radius with external fixator. Follow-up--complications--outcomes].
The performance of the external fixation regarding severe fractures of the distal radius was evaluated by means of a very detailed retrospective study. Between 1989 and 1994 74 Patients with 76 fractures of the distal radius with a mean age of 69 years for female and 39 years for male patients were treated with the external fixator. 37% were open fractures. Using the ASIF classification, 21% were type A-fractures, 8% were type B-fractures and 71% were type C-fractures. In 44 cases the external fixator was used primarily, in 32 cases secondarily after failed conservative treatment. Additional procedures were partially necessary (K-wires, screws, bone grafts etc.). 32 complications had to be noted, the lesion of the superficial branch of the radial nerve being the most common (16%). After a mean follow up of 36 months 60 patients with 61 fractures could be evaluated clinically and radiologically. With the Sarmiento score as well as the Castaing score, 84% could be classified as very good or good, 16% as fair, no poor results were recorded. From this study we conclude that the primary treatment of complex fractures of the distal radius can be performed with external fixation along with the additional procedures necessary (K-wires etc.). Because of the reliable elimination of pain caused by the fracture, it forms a preventive measure against reflex sympathic dystrophy.
Kuner
E H
EH
Abteilung Unfallchirurgie, Chirurgische Universitätsklinik, Hugstetterstrasse 55, 79106 Freiburg.
Mellios
K
K
Berwarth
H
H
D000328:Adult; D000368:Aged; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D011885:Radius Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D014954:Wrist Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*