[External fixation of distal radius fractures: indication, technique and functional results]

A series of 56 consecutive patients with 59 fractures of the distal end of the radius, treated with an unilateral external fixator of Hoffmann between 1980 and 1988, is presented, 47 of these patients were examined clinically at home in the last months of 1989. We can distinguish two different groups of patients: the older females with an average of 59.2 years and the younger males with an average of 40.1 years. The fractures of the females were caused by a lower energy trauma than those of the males (p less than 0.05). The males had significantly more complex fractures (Frykman type VII or VIII) than the females (p less than 0.05). The indication for an external fixation was significantly different for males and females (p less than 0.01). The external fixator remained attached for an average time of 5.7 weeks. The traumatized wrist had an average power of 71% of the heterolateral side. 87% of the patients had no complaints in performing their daily activities. In 70% there was an anatomical reduction on the X-ray, in 64% an excellent cosmetic result and in 68% the functional end results were excellent or good. Functional end results can be ameliorated by paying more attention to the anatomical reconstruction of the wrist joint. Therefore, it can be necessary to complete the external fixation with an open reconstruction of the wrist joint and/or with a transplantation of cancellous bone. In some cases, a changing of procedure to a plate osteosynthesis could be the treatment of choice.