External Fixation for Fractures of the Distal Radius.

概要

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External fixation apparatus is a feasible treatment for unstable fracture of the distal radius. We have used two types of apparatus, static and dynamic type. The static type provides rigid immobilization for several weeks after operation. The dynamic type allows early motion of the wrist with the apparatus. Results with these two types were analyzed in a consecutive series of 39 unstable distal radial fractures. The Ace-Colles external fixator was used in 17 patients and the small Hoffmann fixator was used in 4. The Clyburn dynamic external fixator was used in 16 patients and Penning model was used in 2.The maintenance of reduction with the dynamic type was the same worth of the static type by using the Kirshner-wire fixation. Although the patients treated with dynamic type started the exercise of the wrist motion at an average day of 18 after operation, the recovery of the range of motion was not earlier than the recovery treated with static type. Clinical results as assessed according to Satio's point system demonstrated no significant difference between two types.To provide rigid fixation, early ROM recovery and early social recovery, we need the dynamic external fixation with Kirshner-wire fixation for the dorsal fragment and ROM exercise of the wrist as early as possible after operation.