Can external fixation maintain reduction after distal radius fractures?

Area of Science:

• Orthopedic surgery
• Traumatology
• Radiography

Background:

• Distal radius fractures are common injuries requiring effective management.
• Maintaining fracture reduction is crucial for optimal functional outcomes.
• External fixation and percutaneous pinning are common surgical techniques used for distal radius fractures.

Purpose of the Study:

• To evaluate the effectiveness of external fixation and percutaneous pinning in maintaining distal radius fracture reduction over six months.
• To identify potential predictors of loss of fracture reduction after surgical fixation.

Main Methods:

• Seventy distal radius fracture cases underwent radiographic evaluation pre-surgery, post-surgery, and at 6-week, 3-month, and 6-month follow-ups.
• Key radiographic parameters assessed included volar tilt, dorsal displacement, radial inclination, radial height, radial shift, and ulnar variance.

Main Results:

• Initial dorsal tilt averaged 17.5 degrees, corrected to 0.9 degrees post-surgery, but progressed to 4.2 degrees at 6 months.
• Nearly half (49%) of cases experienced a loss of over 5 degrees in volar tilt by 6 months.
• No patients transitioned from an acceptable to an unacceptable reduction; initial deformity, age, bone graft use, and fixation duration did not predict reduction loss.

Conclusions:

• A notable loss of volar tilt reduction can occur up to six months post-fixation, even with pinning.
• No specific factors reliably predicted this loss of reduction.
• A trend suggested a higher likelihood of reduction loss in younger patients.