[Treatment of AO type C2-C3 fractures of the distal end of the radius with external fixation].
OBJECTIVE
We evaluated the results of combined treatment with closed reduction, grafting, K-wires, and external fixation in patients with fractures of the distal end of the radius.


METHODS
Of 24 patients (15 males, 9 females; mean age 34 years; range 21-73), 16 patients had C2, eight patients had C3 fractures according to the AO classification. Three patients had open fractures, and four patients had signs of median nerve compression. Treatment included closed reduction, autologous grafting (16 cases) followed by fixation with 2 to 5 K-wires, and an external fixator. Clinical and radiographic results were assessed according to the Gartland-Werley's and Stewart's criteria, respectively, and degenerative changes to the Knirk-Jupiter's criteria. The mean follow-up was 35 months (range 25 to 52 months).


RESULTS
All of the 19 patients who were employed returned to preinjury working conditions in a mean of 3.5 months. Radial length was preserved to a great extent. The mean amount of collapse of the joint surface was 1.4 mm. The mean loss was 6.7% in radial inclination, and 17.6% in the volar tilt. According to the Stewart's criteria, the results were good, moderate, and poor in 12, nine, and three patients, respectively. Flexion-extension (75%), supination-pronation (70%), and radial-ulnar deviation (75%) were preserved to a great extent. Grip force amounted to 70% of the healthy side. According to the Gartland-Werley criteria, three patients had excellent, eight patients had good, 10 patients had moderate, and three patients had poor results. According to the Knirk-Jupiter's criteria, degenerative changes were slight in 11 patients, moderate in six patients, and severe in one patient. Six patients had no signs of degeneration. Complications included pin track infections (n=4), early transient reflex sympathetic dystrophy (n=2), and hypoesthesia along the superficial branch of the radial nerve (n=2).


CONCLUSIONS
Treatment of the distal end fractures of the radius (AO type C2-C3) with a combination of external fixation, grafting, and percutaneous K-wires provides almost normal radiologic and clinical parameters.
Kömürcü
Mahmut
M
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Gülhane Military School of Medicine, Ankara, Turkey. mkomurcu@hotmail.com
Kamaci
Levent
L
Ozdemir
M Taner
MT
Ateşalp
A Sabri
AS
Başbozkurt
Mustafa
M
D000328:Adult; D000368:Aged; D001864:Bone Wires; D003100:Colles' Fracture / Q000473:pathology / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries; D008875:Middle Aged; D016059:Range of Motion, Articular; D016896:Treatment Outcome