External fixation of complex carpal dislocations: a preliminary report

Area of Science:

• Orthopedic Surgery
• Traumatology
• Hand Surgery

Background:

• Complex carpal fracture dislocations present significant challenges in achieving stable reduction and optimal functional recovery.
• Traditional treatments may involve prolonged immobilization, potentially leading to joint stiffness and reduced patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of an external fixator as an adjunct to open reduction and internal fixation (ORIF) for complex carpal fracture dislocations.
• To assess the benefits of continuous postoperative wrist distraction in maintaining carpal stability and facilitating early rehabilitation.

Main Methods:

• Ten cases of complex carpal fracture dislocations were treated using ORIF combined with an external fixator bridging the radius and metacarpals (second or third).
• The external fixator provided continuous distraction of the wrist postoperatively.

Main Results:

• The external fixator facilitated reduction, ligamentous repair, and internal fixation of carpal bones.
• Continuous postoperative distraction maintained stable carpal reduction, enabling cast-free treatment and early active motion of adjacent joints.
• This technique proved particularly useful in cases with coexisting injuries of the same extremity.

Conclusions:

• The use of an external fixator as an adjunct to ORIF is an effective method for managing complex carpal fracture dislocations.
• This approach promotes stable fixation, allows for early mobilization, and improves outcomes, especially in polytraumatized patients.