Treatment of Selected Distal Radius Fractures with Nonbridging External Fixation

A nonbridging external fixation (NBX) system with 1.6-mm diameter pins provided excellent stability for distal radius fractures in cadavers. For the present study, all patients with distal radius fractures were seen by the surgeon authors. Fractures that were displaced and unstable, including Orthopaedic Trauma Association (OTA) types 23-A2.3 to C3.3, were reduced and fixed with the NBX system. The Western Institutional Review Board granted approval (296864) for this retrospective study. Fractures numbered five OTA-A2, eight OTA-A3, two OTA-B3, one OTA-C1, two OTA-C2, and eight OTA-C3. In total, the study included 26 patients. At fixator removal, average dorsiflexion was 37.0° ± 17.8°; volar flexion, 39.4° ± 17.2°; pronation, 80.6° ± 16.1°; and supination, 48.1° ± 24.2°. Follow-up averaged 11.7 mo ± 19.2 mo. At final follow-up, average dorsiflexion was 52.9° ± 25.0°; volar flexion, 53.1° ± 23.7°; pronation, 80.8° ± 14.5°; and supination, 67.7° ± 30.3°. Average radial tilt at the time of injury was 11.6° ± 8.3°; post op to 23.9° ± 5.0°; and at last follow-up, 23.1° ± 5.0°. Average radial styloid length at the time of injury was 4.1 mm ± 3.7 mm; post op to 11.4 mm ± 3.0 mm; and at last follow-up, 10.5 mm ± 3.1 mm. Volar tilt at the time of injury averaged -19.6° ± 14.8°; reduced to 9.8° ± 6.3°; and at last follow-up, 7.5° ± 6.5°. This form of nonbridging fixation is safe and effective at maintaining reduced, extra- and intra-articular, distal radius fractures and allows functional range of motion with minimal complications.