Dynamic vs static external fixation of distal radial fractures: A randomized study

Area of Science:

• Orthopedics
• Traumatology
• Surgical Innovation

Background:

• Displaced unstable comminuted distal radius fractures require effective management to restore function.
• External fixation is a common treatment modality, with static and dynamic options available.

Purpose of the Study:

• To compare functional and anatomical outcomes of dynamic multiplanar external fixation versus static external fixation for distal radius fractures.
• To evaluate the correlation between anatomical restoration and functional outcomes.

Main Methods:

• A randomized study of 60 adult patients with distal radius fractures.
• Comparison between Penning-type articulated dynamic fixator and Joshi's external stabilizing system (JESS) static fixator.
• Outcomes assessed using Gartland and Werley, DASH, and Lindstrom scores over 2 years.

Main Results:

• The dynamic Penning fixator group showed better palmar tilt restoration and less loss of ulnar tilt and radial height.
• Early functional outcomes (Gartland and Werley scores) favored the dynamic fixator group.
• No significant difference in DASH scores was observed between groups at 2 years.

Conclusions:

• Articulated multiplanar external fixation with early dynamization improves early functional and anatomical outcomes for distal radius fractures.
• Static external fixation is a viable alternative, with comparable long-term functional results.
• Correlation between anatomical and functional outcomes was poor at 2 years.