Closed reduction and external fixation of unstable fractures of the distal radius

The anatomical and functional outcome and complications after closed reduction and external fixation of unstable fractures of the distal radius were reviewed in 29 patients. The fractures were reduced by longitudinal traction and closed manipulation under fluoroscopic control, and the reduced position was retained by a standard half-frame Hoffmann external fixator for six to eight weeks. The mean follow-up time was four (3-7) years. The reduction failed in three patients after too early removal of the fixator (three to five weeks). For the rest of the patients the dorsal angulation, the radial length, the articular step-off, and the intra-articular gap between fragments were significantly improved. Twenty-two patients had excellent or good anatomical alignment and in seven it was fair. One patient had a superficial pin infection, six patients had transient paraesthesias, and one patient transient mild dystrophia. At follow-up one patient had some finger stiffness; this was the only persistent complication. The median Gartland and Werley functional score was 3. The functional end result was excellent or good in 22 patients, fair in four, and poor in three.