Summary
A series of 56 consecutive patients with 59 fractures of the distal end of the radius, treated with a unilateral Hoffmann external fixator between 1980 and 1988, is presented. Forty-seven of these patients underwent clinical re-examination at home. We could distinguish two different groups of patients: an older female group with an average age of 59.2 years and a younger male group with an average age of 40.1 years. The fractures in the women were caused by lower energy trauma than those in the men (P < 0.05). The men had significantly more complex fractures (Frykman type VII or VIII) than the women (P < 0.05). The indications for external fixation were significantly different in men and in women (P < 0.01). The external fixator remained in place for an average of 5.7 weeks. The injured wrist had on average 71% of the strength of the contralateral wrist. Eighty-seven percent of the patients had no complaints in performing their daily activities. In 70% X-ray showed anatomical reduction, in 64% there was an excellent cosmetic result and in 68% the functional end results were excellent or good. Functional end results can be ameliorated by paying more attention to anatomical reconstruction of the wrist joint. It may be necessary to supplement the external fixation with open reconstruction of the wrist joint and/or a cancellous bone transplant. In some cases, a change of procedure to plate osteosynthesis could be the treatment of choice.
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References
Alffram Pa, Bauer G (1962) Epidemiology of fractures of the forearm. J Bone Joint Surg [Am] 44:105–114
Anderson R, O'Neill G (1944) Comminuted fractures of the end of the radius. Surg Gynecol Obstet 78:434–439
Bauer GCH (1960) Epidemiology of fractures in aged persons. A preliminary investigation in fracture etiology. Clin Orthop 17:219–225
Castaing J (1964) Les fractures récentes de l'extrémite inferieure du radius chez l'adulte. Rev Chir Orthop 50:581–596
Chamay A (1977) Considérations sur les limites de tolérance du traitement conservateur des fractures du poignet. Ann Chir 31:340–342
Chamay A, Meythiaz M, Della Santa D (1983) Treatment of unstable fractures of the wrist using Hoffmann's external fixator. Study of a series of 40 cases. Rev Chir Orthop 69:637–643
Cooney WP, Lindscheid RL, Dobyns JH (1979) External pin fixation for unstable Colles' fractures. J Bone Joint Surg [Br] 61:840–845
Frykman G (1967) Fractures of the distal radius including sequelae — shoulder-hand-fingers syndrome disturbance in the distal radio-ulnar joint and impairment of nerve function. Acta Orthop Scand [Suppl] 108
Gartland JJ, Werley CW (1951) Evaluation of healed Colles fractures. J Bone Joint Surg [Am] 33:895–907
Jakob RP (1982) Le petit fixateur externe. AO-Bulletin
Lidström A (1959) Fractures of the distal end of the radius. Acta Orthop Scand [Suppl] 41:5–14
Kongsholm J, Olerud C (1987) Comminuted Colles' fractures treated with external fixation. J Orthop Trauma Surg 106:220–225
Rehn J (1965) Behandlungsergebnisse typischer Radiusfrakturen. Chirurg 35:266–272
Sarmiento A, Pratt GW, Berry NC, Sinclair WF (1975) Colles' fracture. Functional bracing in supination. J Bone Joint Surg [Am] 57:311–317
Tscherne H, Jähne E (1990) State of the art of therapy for fractures of the distal radius. Unfallchirurg 93:157–164
Vidal J, Allieu Y (1972) Fractures de l'extrémité inférieure de l'avant-bras. In: Encycl Méd Chir. Appareil locomoteur, vol 2, pp 14041–14042
Vidal J, Buscayret C, Fischbach C, Brahin B, Poran M, Escare P (1977) Une méthode originale dans le traitement des fractures comminutives de l'extrémité inférieure du radius: ≪ Le taxis ligamentaire ≫. Acta Orthop Belg 43:781–786
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Rommens, P.M., Vanderschot, P.M. & Broos, P.L. External fixation of the distal end of the radius: the same technique for different patient populations?. Arch Orthop Trauma Surg 111, 165–170 (1992). https://doi.org/10.1007/BF00388092
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DOI: https://doi.org/10.1007/BF00388092