Treatment of unstable distal radius fractures with a small AO-fixateur externe not bridging the joint

Abstract

This retrospective study investigated the stability of the small AO external fixator in a radioradial configuration used in the treatment of 42 mostly unstable distal radius fractures (types A-3.2, C-1.2 and C-2.1 according to the AO classification). No bone grafting was performed. All cases were documented with antero-posterior and lateral X-rays preoperatively, 0, 2 and 6 weeks postoperatively and after consolidation. Early functional aftertreatment was started one week after surgery. Thirty-six fractures showed a dorsal comminution, combined with osteopenia in 18 cases. The mean preoperative radial angle of 17 degrees was normalized to 25 degrees postoperatively. The mean preoperative volar angle of minus 30 degrees was reduced to 12 degrees postoperatively. None of these mean angles changed until consolidation. The external fixator was removed on average after 7 weeks (range 6-10 weeks) depending on the radiological fracture healing. The small AO external fixator in a radioradial configuration proved to be stable enough for early functional aftertreatment of the wrist. Its stability is related to a proper operative technique and correct indication (unstable Colles type with one or two distal fragments). Bone grafting is unnecessary if the external fixator is left in situ until bony consolidation.