title: [Minimally invasive treatment for distal radial fracture and dislocation of type IV based on Fernandez classification].
abstract: OBJECTIVE
  To investigate the effects of external fixation combined with minimally invasive internal fixation for the treatment of distal radial fracture and dislocation of type IV based on Fernandez classification.
  
  
  METHODS
  From January 2007 to October 2012,19 patients with the distal radius fracture and dislocation of type IV according to Fernandez classification were reviewed. There were 14 males and 5 females,ranging in age from 22 to 42 years old,with an average of 36.5 years old. All the patients were treated with minimally invasive reduction, and external fixation with finite internal fixation. The K-wire was used to fix radiolunate articular surface for correcting the instability of dorsal and volar intercalated segment. The radiolunate angle, scapholunate angle, and the length of the radial shorting were measured by the standard X-ray. Gartland and Werley evaluation system was used to evaluate recovery of function.
  
  
  RESULTS
  No complications such as injury of blood vessels and radial nerves and pin track infections occurred. After operation, the radiolunate angle, scapholunate angle and the length of the radial shorting time were (9.5 +/- 3.3) degrees, (51.3 +/- 11.2) degrees and (11.2 +/- 1.8) mm by the standard X-ray. On the 3rd month after operation, GW score was 3.02 +/- 3.05. There was no re-displacement and subluxation occurred during the follow-up period. Good functional recovery were improved wrist function significantly.
  
  
  CONCLUSIONS
  External fixation combined with minimally invasive internal fixation can treat distal radial fracture and dislocation of type IV based on Fernandez classification. Wrist joint stability depends on the structure of the bone and ligament around wrist joint. Emphasis on the diagnosis and treatment of carpal instability, and postoperative functional rehabilitation can improve wrist function.
authors.forename: Jun-Liang
authors.initials: JL
authors.lastname: Fei
authors.forename: Bin
authors.initials: B
authors.lastname: Liang
authors.forename: Chun-Zhi
authors.initials: CZ
authors.lastname: Jiang
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Wang
mesh_terms: D000328:Adult; D001858:Bone Nails; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011885:Radius Fractures / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000503:physiopathology / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult