[Treatment of fractures of the distal part of the forearm using external fixation]

In the years 1986-1987 the authors operated on 14 patients with 15 fractures in the area of the distal part of the forearm. They performed external fixation in open fractures and in unstable, intra-articular and extra-articular closed fractures. They use Poldi 7 external fixation device, the clamp type of fixation with the insertion of 2 screws into the radius and 2 screws into the second metacarpal. Reduction is carried out by distraction using the principle of ligamentotaxy. The evaluation of the results in the period between' 8-22 months after the operation showed excellent clinical results in 6 patients, good results in 7 patients and a fair result in one elderly female patient where a sizable radionulnar synostosis occurred during healing. Subjective feelings evaluated ten times as excellent and four times as good. In one patient the choice of the method of treatment was incorrect; an extensive lesion of ligamentary apparatus did not allow the correct reduction of fragments by distraction it was necessary to perform open reduction and transfixation of the fragments by means of K-wires, This patient was not included into the clinical results. Other more serious complications were not found out. Proceeding from their own experience the authors present some of the advantages of the method used: 1. Easy reduction and reliable retention of fragments 2. Possibility of the control and treatment of the damaged soft tissues 3. Possibility to perform additional operations without the danger of losing the reduction achieved a) fasciotomy b) spongioplasty c) skin grafts