[Continuous skeletal traction in multifragmentary fractures of radius and ulna combined with cast]

Fractures of the distal third of the radius are frequently encountered in emergency services. Until recently considered as benign, however, they represent a group of numerous therapeutic problems, as debated in anatomical, radiological and clinical studies.

To emphasize the importance of recovering the radial distance and the articular congruence in fractures of radius treated with a cast.

To demonstrate that ligamentotaxis obtained with the application of the Cole-Obletz technique is a good method for treatment of distal radius fractures that have a component of impaction, extra or intra-articular lesion, a combination of both.

A retrospective study was realized on 10 patients with fractures of the distal radius, between February 2005 and February 2006, including adult patients of both genders. All patients received the Cole-Obletz method and were evaluated by antero-posterior and lateral wrist simple X-rays. According to Frykman classification, we compaired results in the immediate post-reduction X-rays with the results obtained at one month of treatment. Three different radiographic measures were evaluated: radius distance, inclination and volar tilt of the radius.

We evaluated a group of 10 patients (80% female), with mean age of 52 years-old (24-79). Thirty percent of the patients (30%) presented a type VIII fracture, fourty percent a type VII fracture, and one patient for types V, IV, and II fractures, respectively. Articular congruence was achieved in the 80% of patients until full consolidation, in 10% of the patients only a 50% of radius distance was completed. In a patient anatomic reduction was lost on day eight.

Treatment of complex distal radius fractures with plates and screws for maintaining anatomic reduction are not applicable in our socioeconomic context. This study was aimed to prove that the Cole-Obletz method permits to maintain adequate reduction, it is reproducible, and is achievable at low costs.