Reduction of treatment-related complications in the external fixation of complex distal radius fractures

Treatment-related complications in the external fixation of complex distal radius fractures may be diminished by the insertion of 4-mm, self-tapping half-pins after predrilling. The pins are placed proximally in the radius and distally through six cortices of the second and third metacarpals. An adaptable fixation device that allows reduction after pin insertion and assembly is recommended. It must allow enough mobility to completely reduce a very unstable fracture after its application. A limited open surgical approach allows direct visualization of the bone where the fixator pins will be placed, as well as central insertion of the pins. It avoids eccentric drill placement, open section defects, redrilling, and damage to soft-tissue structures.