Functional Outcome After Internal Fixation Combined with External Fixation in Severe Comminuted Distal Radius Fracture: A Case Report

Abstract

Introduction: It has been 192 years since Colles first demonstrated distal end fracture of radius. Nowadays, this type of fracture still became challenging fractures treated by orthopaedic surgeons. Even this type of fractures were common of the upper limb, the appropriate management still remain debateable. Various type of management have been demonstrated, it’s included immobilized with cast, closed reduction and fixation with percutaneous Kirschner wires and other methods for external and internal fixation. Case Presentation: Patient is female 16 years old complained pain on her left wrist after traffic accident on (October 2019). Patient was diagnosed in Singaraja Hospital with Open Fracture Left Distal Radius and Ulna distal third grade 3A, Patient was performed debridement and open reduction external fixation at the distal radius. Patient was referred to Orthopaedic polyclinic at Prof IGNG Ngoerah hospital due to inadequate alignment after evaluation of 3 weeks post operation. In Prof IGNG Ngoerah Hospital, we performed additional ORIF T-Plate 6 holes with 6 screws on radius and ulnar percutaneous pinning in order to provide additional stability to the comminuted distal radius fracture. Conclusion: Combination of external fixator with T-plate internal fixation decreased re-shifting postoperatively of broken bones chances and kept the stability of fractures to sustain radial height and prevent radial shortening. Thus, it is a safe and effective method for comminuted-type fracture of distal radius. Keywords: External Fixation, Comminuted Fracture, Distal Radius