title: Can external fixation maintain reduction after distal radius fractures?
abstract: BACKGROUND
  The purpose of this study was to assess the effectiveness of external fixation and percutaneous pinning in maintaining distal radius fracture reduction over a 6-month period and to identify factors that might predict loss of fracture reduction.
  
  
  METHODS
  Seventy cases had complete radiographic evaluation before surgery; at surgery; and at 6-week, 3-month, and 6-month follow-up. Radiographic parameters measured included volar tilt, dorsal displacement, radial inclination, radial height, radial shift, and ulnar variance.
  
  
  RESULTS
  Dorsal tilt averaged 17.5 degrees from neutral before surgery; this value was corrected to 0.9 degree at surgery, but then progressed to 4.2 degrees by the 6-month follow-up. At 6-month follow-up, 49% of cases had lost more than 5 degrees of initially reduced volar tilt. However, none of these patients went from an acceptable initial reduction to an unacceptable reduction at 6 months. Initial deformity, patient age, use of bone graft, and duration of external fixation were not predictors of loss of reduction.
  
  
  CONCLUSIONS
  Loss of reduction of volar tilt was seen for a period of up to 6 months after fixation, despite the use of pinning to hold the reduction. No specific predictor of loss of reduction was noted, although there was a trend toward loss of reduction in younger patients.
authors.affiliation: New York University Hospital for Joint Diseases Orthopaedic Institute, New York, New York 10016, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Dicpinigaitis
authors.forename: Philip
authors.initials: P
authors.lastname: Wolinsky
authors.forename: Rudi
authors.initials: R
authors.lastname: Hiebert
authors.forename: Kenneth
authors.initials: K
authors.lastname: Egol
authors.forename: Kenneth
authors.initials: K
authors.lastname: Koval
authors.forename: Nirmal
authors.initials: N
authors.lastname: Tejwani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*