[External fixation at the wrist and hand]

Distraction radio-metacarpal external fixation is an excellent technique for the osteosynthesis of distal radius fractures, in particular of comminuted articular fractures. The alternative is the locked palmar plate, a more demanding technique. The published literature does not allow concluding if one method is better than the other. The other main possible indications of external fixation at the wrist are comminuted fractures of the base of the thumb metacarpal, distal radius osteotomies, and wrist arthrodeses. At the hand, external minifixation is an excellent technique of osteosynthesis. Stable bone fixation is obtained, allowing early active mobilization of the fingers. The technique is especially indicated to treat open lesions or to perform lengthening, but we use also external minifixation to treat closed fractures, to perform arthrodesis or to cure non-unions, and to maintain the length of the thumb after trapeziectomy for osteoarthrosis.