Management of fracture of distal radius by external fixator using the principle of ligamentotaxis a prospective study

Abstract

Background and objectives: Fracture of distal end of radius continues to be one of the most common skeletal injuries since the description by Poteau in 1783 and by Colle’s in 1814. Management of these fractures is still a challenge for orthopaedic surgeon in achieving good functional results. Numerous techniques have been described and developed to treat the fracture in an effort to improve the outcome. A prospective study of management of fracture-distal radius by external fixator using the principle of ligamentotaxis was conducted at our institute to evaluate the clinical efficacy of external fixator with ligamentotaxis in distal radius fracture reduction, fracture healing, functional recovery after surgery and common complications encountered. Methods: A prospective study of 30 cases of fracture lower end of radius in age group 20-60 years was done who were treated with ligamentotaxis in the department of orthopaedics at our institute from June 2008-october 2011. Fracture was anatomically reduced and fixed with Joshi`s external fixator with ligamentotaxis. All patients were monitored for pin tract infection and other complications. Active finger movements were advised by the patient from second post operative day. Regular clinical examination, periodical check X-rays were taken to assess the union of fracture. Patients were followed up to 2years with average duration of 9 months. Results: We found that in all cases there was union of fracture on an average of 6weeks. There was no case of non union; there were 5 cases of acceptable malunion and 4 cases of joint stiffness and one case of pin tract infection. Interpretation and conclusion: With external fixation and ligamentotaxis the result in majority of cases was either excellent or good. Hence we concluded that external fixator with ligamentotaxis is a good method of treatment in fracture distal end of radius. Key words: Distal end radius, Colle’s fracture, ligamentotaxis, External fixation, closed reduction