Secondary displacement of distal radius fractures treated by bridging external fixation

Loss of reduction remains an important problem after treatment of distal radius fractures, whatever the type of bone fixation. We assessed retrospectively the rate of secondary displacement after external fixation of distal radius fractures in order to identify possible risk factors for instability. We reviewed the pre-operative and serial post-operative radiographs of a retrospective series of 35 distal radius fractures treated by bridging external fixation. When classified according to the Société Française d'Orthopédie et Traumatologie (SOFCOT) criteria, the rate of secondary displacement was 48.5%. At final follow up, the reduction was anatomical in 12% and acceptable in 83%. There was malunion in 5%. The loss of reduction concerned primarily the distal radius palmar tilt and was moderate. No correlation was found with age, gender, type of fracture, degree of initial displacement, associated ulnar fracture, or seniority of the treating surgeon.