Abstract
Background: Distal radius fractures are frequent in emergency departments, treatment is generally conservative, but there are patients who meet certain criteria of instability who need surgical treatment, including external fixation. Aim: To update on the most important elements regarding the use of external fixation in unstable fractures of the distal radius. Methods: The search and analysis of the information was carried out in a period of 30 days (from April 1 to April 30, 2021) and the following words were used: distal radius fractures, distal radius fractures and external fixation and unstable radius fractures from the information obtained, a bibliographic review of a total of 809 articles published in the PubMed databases, Hinari, SciELO and Medline was carried out using the search manager and EndNote reference manager, of which 44 selected citations were used to perform the review, 37 from the last five years. Development: The criteria to be taken into account for the instability described by various authors are indicated, as well as the imaging parameters. The two most used classification systems are mentioned. Reference is made to general surgical indications, external fixation, and placement of additional wires. Complications are discussed and a comparison is made between external fixation and blocked volar plates.
Highlights
Fractures of the distal end of the radius (FDER) are one of the most frequent, according to Egol KA et al [1] represent one in six fractures treated in emergency services and 16 % of all fractures attended by specialists in Orthopedics and Traumatology
40 years of age, it has an incidence of 368 per 100,000 and above 40 years the incidence is 1,150 per 100,000 inhabitants. [2,3,4] FDERs are caused by high-energy trauma in the young patient and low-energy trauma in the elderly caused by axial compression of the limb with the wrist in 40-90 degree extension
The search and analysis of the information was carried out in a period of 30 days and the following words were used: distal radius fractures, distal radius fractures and external fixation and unstable radius fractures from the information obtained, a bibliographic review of a total of 809 articles published in the databases
Summary
Fractures of the distal end of the radius (FDER) are one of the most frequent, according to Egol KA et al [1] represent one in six fractures treated in emergency services and 16 % of all fractures attended by specialists in Orthopedics and Traumatology It affects approximately 650,000 people a year in the United States of America. [2,3,4] FDERs are caused by high-energy trauma in the young patient and low-energy trauma in the elderly caused by axial compression of the limb with the wrist in 40-90 degree extension. In the latter case, bone fragility fractures are considered. Journal of Orthopedic Practice location at the same level of the ulnar and radial styloids, which is observed in patients with displaced fractures. [1,8] conservative treatment is the most widely used, there are situations in which surgical intervention is necessary through placement of wires, plates and screws, in addition to external fixation (EF). [9,10] EF offers multiple advantages due to its relative ease of application, is justified in most fracture patterns, and can be combined with other surgical procedures. [11,12] Due to the importance of this topic and the large number of patients with this traumatic entity who may need EF, a review of the topic was carried out with the guiding objective of updating on this surgical modality
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