External fixation for distal radius fractures: effect of distraction on outcome

Few studies have examined the potential adverse effects of excess distraction and prolonged duration of external fixation for the treatment of distal radius fractures. In this study, 19 patients with distal radius fractures treated with external fixation and supplemental Kirschner wire fixation between August 1991 and November 1997 were studied retrospectively. Patients were evaluated by questionnaire, chart review, radiographs, and clinical examination an average of 161 weeks after injury. Although no significant correlation was found between amount of distraction, as measured by carpal height index, and scores for pain, function, radiographs, motion, grip, strength, and final result, a negative correlation was found of all categories with increasing carpal height index. A significant negative correlation was seen between duration of external fixation and scores for pain, motion, and total score, with motion scores being most affected. New York Orthopaedic Hospital grades of good or excellent were attained by 89% of the patients. The data suggest that external fixation with supplemental pin fixation is a satisfactory method of treating severe fractures of the distal radius. Outcome likely is improved with shorter duration of external fixation.