Lower End Of Radius Research Articles

The study of outcome of non comminuted lower end radius fractures treated by closed reduction and internal fixation with percutaneous pinning

Introduction: Fractures of the distal radius constitute one of the most common skeletal injuries treated by orthopaedic surgeons. Colle’s fracture was first described by Abraham Colle of Dublin in Ireland. There are variety of treatment modalities in treating extraarticular non-comminuted fractures of distal radius. Each one has got their own advantages and disadvantages. Increased life expectancy of the population increases and as accidents also increase, the incidence of this fracture is expected to increase. Percutaneous pinning is one of the most simple, cost effective, easy procedure with good results. This study was conducted to analyze the outcome of Distal Radial Fractures treated with closed reduction and percutaneous pinning.Materials and Methods: This is a prospective study of 30 cases of distal radius fractures. non-comminuted aged between 20 to 70 years of age. They were treated with closed reduction and internal fixation with Percutaneous pinning with 2-3 K-wires. Postoperatively they were immobilized with below elbow dorsal slab. After 3 weeks slab was removed and physiotherapy started, K-wires were removed after 6 weeks. Post operative xrays were done at 3 weeks, 6 weeks and 6 months.Results: There were 30 cases in our study. 60% (18) males and 40% (12) females. The mean age of the patients was 52 years. The mechanism of injury in most cases was fall on out stretched hand 76.6% (23). The side of involvement was right in 56% (17) and 44% (13) in left hand. 66% (19) belonged to type A, 34% (10) belonged to Type C according to Fernandez classification. 54% (16) patients belonged to A type, 36% (11) belonged to type B as per AO classification. 60% (18) showed excellent outcome under subject evaluation, 67% (20) patients showed excellent end results. Total 13% (4) showed complications in the study. Among them 7% (2) were pin tract infection, followed by malunion and Reflex Sympathetic Dystrophy each 3% (1).

Results of open reduction and fixed angle locked volar plate fixation for fracture lower end of radius

<p class="abstract"><strong>Background:</strong> The fracture of lower end radius is the most common fracture of upper extremity encountered in practice. Intra-articular fractures of distal radius present a challenging task to the operating surgeon. Open reduction and internal fixation using volar fixed-angle plates has shown to be a valid treatment option for unstable, dorsally displaced distal radial fractures. The present study was undertaken to evaluate the functional outcome of unstable distal radius fractures treated with fixed angle volar locking plate.</p><p class="abstract"><strong>Methods:</strong> The current study aimed at using fixed angle volar locking plate to treat unstable distal radius fractures. A total of 25 patients records were studied comprising of 19 males and 6 females with a mean of 44.5 years and followed up for a maximum of 1.5 year. Fractures were classified using the AO classification. The interpretation of functional outcome was done according to Mayo Wrist Score.<strong></strong></p><p class="abstract"><strong>Results:</strong> At final functional assessment, according to the Mayo wrist score, the scores of 6 patients were excellent, 10 patients good, 8 patients satisfactory and 1 patient poor. No non-union was reported in any patients. 3 patients developed minor complications in the form of superficial infection, hypertrophic scar and reflex sympathetic dystrophy and 1 patient developed major complication in the form of deep infection.</p><p class="abstract"><strong>Conclusions:</strong> Primary volar plate fixation of unstable distal radius fracture provides a stable construct that helps in early mobilization, better functional outcome and minimizes chances of complications and thereby is the treatment of choice for fracture distal end of radius.</p>

Is direct reduction and rigid fixation osteosynthesis better than ligamentotaxis for comminuted intra articular lower end radius fractures?

Introduction: The distal radius has a complex kinematics for the radiocarpal and the radioulnar joints. Perfect restoration of the radial length, volar angulation and radial inclination are mandatory for complete restoration of the wrist function. Ligamentotaxis, and Open Reduction with Internal Fixation (ORIF) are the most commonly practiced two methods, to achieve the above goals in the current era of Orthopedic Practice. In this study, the functional and radiological outcomes of both Direct Reduction and Rigid fixation (ORIF with Volar Plating) and Ligamentotaxis were analyzed, to find out the best option among the two.Materials and Methods: This Prospective study was conducted in Department of Orthopedics KMCT medical college, a tertiary level health delivery institution in South India, from April 2017 to September 2018, of age group, 20 to 70 years, with Isolated closed distal end radius fracture not older than two weeks and classified as AO TYPE C -Distal end radius fracture. Those with Pregnancy, Polytrauma, other injuries in ipsilateral limb and presence of space occupying lesion at wrist were excluded from the study. Twenty patients were selected for each group, and the results were statistically analyzed using Statistical Package for Social Sciences (SPSS) 20.0 software.Results and Conclusions: In our study, on the analysis of the functional and radiological outcomes, we found there are significant advantages for volar locking plate over Ligamentotaxis, as early mobilization of the wrist and less intra/post-operative complications. Hence, it is definitely a better choice for managing Comminuted Intra Articular Distal End Radius Fractures.

Evaluation of functional outcome of immobilisation of extra-articular fractures of distal end of radius in position of dorsiflexion

Background: Cast immobilisation after successful closed reduction is a standard treatment for displaced extra-articular fractures of lower end radius. The position of the wrist during immobilisation is controversial. Immobilisation in dorsiflexion prevents redisplacement after closed reduction. Our aim is to determine the effectiveness of immobilization of wrist in dorsiflexion in such cases and evaluate functional outcome. Materials and Methods: Study included 56 patients, above 20 years of age with closed extra-articular fractures of lower end radius treated conservatively with below elbow cast application. The wrist was maintained in 15° of dorsiflexion during plaster immobilisation. At 24 weeks, functional results were evaluated with subjective symptoms and objective signs, as per modified Demerit Point Score System.Results: 79% of our patients had excellent to good result and 21% had fair result; there was no poor functional outcome.Conclusion: Cast immobilization of extra articular fractures of lower end radius with wrist in dorsiflexion prevents re-displacement of the fragments resulting in satisfactory anatomical & functional outcome.

Study of enders nailing in tibia shaft fracture in paediatric patient

Background and Aim: The exposed anatomical location of the tibia makes it vulnerable to the direct blow and high energy trauma as a result of motor vehicle accidents, thus resulting in comminuted fractures which are frequently open with significant loss of skin and soft tissues. The purpose of our study was to present results of fixation of unstable tibial shaft fractures in children with Ender’s nailing.Material and Methods: This is a study of 30 patients of unstable tibial shaft fractures in children treated with Ender’s nailing. 24 were closed fractures & 6 were open grade one fractures with only punctured wounds. Twenty patients had concomitant fibula fractures. In 26 patients tibia fracture was an isolated injury, one had associated same side clavicle fracture and one had associated same side lower end radius fracture.Results: Average time for fracture union was 9 weeks (range 6 to 15 weeks). All fractures united without 2nd operative intervention. Slight nail back out occurred in many patients, but only in 2 patients significant proximal migration of nails occurred causing some knee irritation, but not requiring any operative intervention before fracture union. In all patients implant removed 6 to 7 months after surgery. There was some restriction of knee movements in 4 patients in which nails were significantly backed out, but after implant removal full knee movements achieved in all patients there was full ankle movements in all patients at final follow-up. Conclusion: Based on our results, Ender’s nailing is an effective method of treatment in these cases, which allows rapid healing of tibial shaft fractures with an acceptable rate of complications.

To study the clinical and radiological outcome of patients with intraarticular or unstable lower end radius fractures treated with ligamentotaxis with external fixator and K wires

Introduction: Treatment for intraarticular lower end radius fractures has been conventionally with closed reduction with plaster /k wires / external fixator or open reduction internal fixation with plate. We thought that by combining external fixator with k wires better anatomical and thus functional results would be obtained.Material and methods: A prospective follow up study was carried out on 50 fresh closed intraarticular or unstable lower end radius at MIMER Medical College Talegaon from June 2014 to May 2018 after taking appropriate consents. Ligamentotaxis with external fixator was combined with k wires under C arm guidance. Patients were followed up at 3,6,9,12 weeks and 6 months clinically and radiographically.Results: Average time for surgery was 34.2 min, radial shortening was less than 4 mm, and hospital stay was 2.3 days. Anatomical assessment was grade l or ll in 96 % patients. Good to excellent results by Lindstrom's criteria was there in 78% patients.Conclusion: Combining external fixator with k wire fixation gives well to excellent results in majority of patients with unstable intraarticular distal end radius fractures without significant complications and with a short hospital stay.

An Observational Study of Radiological Age & Documented Age in 16–20 Years of Age Group in Jaipur

Age estimation is an important exercise undertaken in clinical forensic medicine for various civil & criminal purposes. Present community based Descriptive Observational Study was carried out in S.M.S. Medical College, Jaipur. In this study majority of cases lower end of radius were fused in both genders at 18–20 years of age. The lower end of ulna bone was found to be fused in 69.33% cases. The iliac crest was found fused in 29.34% study subjects. The centre for ischial tuberosity had appeared in 90% males and in 97.44% females between 16–18 years but the process of fusion had not been initiated in any subject below 18 years of age. Complete fusion of ischial tuberosity to the pelvic bone was seen in 40% males and in 19.44% females above 18 years of age. Non-correlation of skeletal age to recorded age as per birth certificates was seen in 36% males and 16% females. Higher discrepancy was observed in rural subjects, non-vegetarian eaters and sports persons. Their skeletal age was ahead of their recorded ages. In a developing country like India, paucity of reliable documentary evidences like birth certificate. Non availability of reliable local data for estimation of age is an incriminating factor for miscarriage of justice.

Application of shujin cleaning agent in postoperative treatment of joint stiffness after small splint for fracture of lower radius

Objective To observe the curative effect of shujin cleaning medicine on the postoperative stiffness of the lower end of radius fracture splint. Methods A total of 100 patients with joint stiffness after the treatment of small splints for fracture of the lower end of radius treated by the hospital were selected as the study objects, and were randomly divided into study group and control group, 50 cases of each group.In the control group, functional exercise and wound oil (preparation of the hospital) were applied and massaged, with warm water applied to the affected area.The research group in the functional exercise, wound oil on the basis of external massage, with the use of shujin washing drugs on the affected areas.By comparing the efficacy evaluation results of the two groups of patients, the curative effect of shujin washout on postoperative joint stiffness of small splint for fracture of the lower end of radius was observed. Results In the study group, 15 cases were cured, 28 cases were marked, 5 cases were effective and 2 cases were ineffective, the total apparent effect(include healing and marked effects) was 43 cases and the total apparent efficiency was 86.0%. In the control group, 10 cases were cured, 15 cases were effective, 13 cases were effective and 12 cases were ineffective, the total apparent effect was 25 cases and the total apparent efficiency was 50.0%.The total effective rate of the research group was significantly higher than that of the control group(P<0.05). Conclusions The effect of shujin washing medicine on the postoperative joint stiffness of the small splint of the fracture of the lower end of the radius is good, which can effectively relieve the joint stiffness after the small splint of the fracture of the lower end of the radius and promote the better recovery of the postoperative function of the patients. Key words: Fracture of lower end of radius; Shujin cleaning medicine; Postoperative nursing of fracture

Study of lower end radius fractures treated with external fixator with or without K wire

Objectives: A prospective study of management of fracture distal radius by external fixator using the principle of ligamentotaxis was conducted from July 2016 to August 2017 at our institute to evaluate the clinical efficacy of external fixator with ligamentotaxis in distal radius fracture reduction, fracture healing, functional recovery after surgery. Material and Methods: 30 cases of fracture distal radius were treated with ligamentotaxis. Inclusion criterias were 1) skeletally mature patients having age more than 18 years 2) closed/unstable fractures. 3) Frykman type 1 to 8 fractures. 4) Fractures with history of trauma

Retrospective Analysis of Giant Cell Tumor Lower End Radius Treated with En bloc Excision and Translocation of Ulna.

Background:Distal end of radius is third most common site for GCT of long bones and 1% of these metastasize mostly to lungs. Reconstruction methods commonly used are fibula (vascularized and nonvascularized), centralization of ulna, translocation of ulna, and endoprosthetic replacement. We report the outcome of series of twenty cases where we did en bloc excision of tumor with translocation of ulna.Materials and Methods:Twenty cases of giant cell tumor (GCT) of lower end of radius were included in this retrospective study. The mean age of patients was 33.15 years (range 21-55 years). We had 14 of Campanacci Grade III and 6 of Grade II. Preoperative radiographs and magnetic resonance imaging of the involved wrist and forearm were done.Results:Of all twenty patients, 14 were males and 6 were females. Mean followup duration was 3.9 years (range 1.5–17 years). Mean grip strength of involved side as a percentage of normal side was 71% (range 42%–86%) and the actual mean value for operated side was 29 kg as compared to 40 kg for normal side. The average range of forearm movement was supination 80.25° (60°–90°) and pronation 77.5° (70°–90°). No patient was dissatisfied as far as cosmesis was concerned.Discussion:In our opinion considering the propensity to recur with more aggressiveness after recurrence, en bloc excision with translocation of ulna has become a standard treatment option for GCT of lower end of radius, with advantages of better functional outcomes, retained vascularity, and elimination of risk of donor site morbidity.

Study of clinical and functional outcomes of unstable intertrochanteric femur fractures treated with long proximal femoral nail

Introduction: The following study was conducted to examine the long term clinical, radiological and functional results of unstable intertrochanteric femur fractures treated with long Proximal Femoral Nail. Materials and Methods: This was a prospective, non-randomized study of 50 cases of intertrochanteric fractures of unstable variety treated by long Proximal Femoral Nail at the Department of Orthopedics, B J Medical College and Civil Hospital, Ahmedabad, between 2014 to 2016. Patients were undergoing primary surgery, with unstable types of fracture pattern AO/OTA type 31A2.2 to 31A3.3. Pathological fractures and patients with previous surgery on proximal femur were excluded. Results: The sample consisted fifty patients, 33 were males and 17 females. The patients’ ages ranged from 18 - 90 years with mean of 68.2 years. Majority (86%) of the intertrochanteric fractures occurred following trivial trauma usually a domestic accident like fall in bathroom or fall from stairs. Associated bony injuries were present in 3 cases (6%). Most common associated injury was fracture lower end radius (in all 3 cases). 29(58%) patients had an osteoporosis Grade 5 while 17 (34%) had Grade 4. AO/OTA Type A2.3 type of fractures were most common in 31 (62%) patients, followed by A2.2, A3.1 and A3.3. Functional Outcome was assessed with modified Harris Hip Score in which 70% of the patients had good to excellent functional results on final follow up at 1 year. Conclusion: The proximal femoral nail, is an optimum implant for the internal fixation of unstable intertrochanteric fractures with advantages of stable fixation, perfect reduction, early weight bearing and ambulation, shortened hospital stay and improved rate of union with early resumption of independent life style.

Volar locking plate in intra-articular fracture lower end radius

Introduction: Fractures of the distal radius recently have become the focus of an intense resurgence in interest regarding optimal management. The overly optimistic attitude that a favourable outcome will eventuate, despite residual deformity must be tempered by the realization that the common factor predisposing to a suboptimal recovery is malunion. Moreover for the most frequently occurring intra-articular fractures, an increasing consensus exists that preservation of distal radial articular contours, that in many cases can be achieved only be open treatment, is an absolute prerequisite for successful recovery. Aim: To evaluate the outcome of volar plating using locked plates in intra articular fractures of lower end radius. Materials and Methods: This is prospective all inclusive study for outcomes of intra articular fracture lower end radius using locked plates as a type of implant for open reduction and internal fixation of the fracture fragments. All patients included for this study sustained distal radius fracture grade III to grade VIII according to Frykmann classification. At the final follow up patients were assessed using Gartland and Werley’s Demerit Scoring System6 for the result of plating of intra articular fracture of lower end radius. Results and Discussion: The results of present study were assessed using using Gartland and Werley’s Demerit Scoring System. We observed that 60.47% patients showed excellent result, 34.89% patients showed good and 4.65% patients showed fair results. These results were quite comparable with other studies performed in the past. Conclusion: Based on our study, we conclude that plating in unstable intra articular fracture of distal end radius using locked plates had become an effective tool in the management of difficult injuries. With the development of volar fixed angle locking plates, this technique is advantageous in intra articular lower end radius fractures.

Evaluation of the Results of Volar Plating in the Treatment of Fractures of Distal End Radius

Background- Fractures of lower end radius are most common fractures of the upper extremity, encountered in practice.Increased awareness of the complexity of the distal end radius fractures have stimulated a growing interest and promoted new ideas regarding their management. Closed reduction and cast immobilisation had been the mainstay of treatment of the DER fractures but complications resulting in poor functional and cosmetic results is usually the outcome. The volar plate system has been shown to be reliable for the fixation of distal radius fractures. As open reduction and volar plating ensure more consistent correction of displacement and maintenance of reduction, this prospective study evaluates the anatomical and functional outcome of open reduction and plate fixation in the management of fracture distal end radius. Objectives: This study was done to evaluate the role of the volar plate in the treatment of fractures of distal end of radius and to evaluate the functional results of this treatment in terms of deformity, disability, movements and grip strength. Assessment of complications that occurred with the surgical procedure was also done. Material and Methods: The study was done in Department Of Orthopedics and Traumatology at USSC, Indore from may 2013 to may 2015. 40 patients with distal end radius fractures were included in the study. Informed consent was taken. Clearance from the ethical committee of the institute was taken. The study was Prospective, interventional and observational for the methods used for management of the fracture. Patients were evaluated pre operatively and post operatively at the end of first,fourth,sixth week,3 months and then once in 3months upto 12 months. Results: In the prospective study conducted with forty patients,88% anatomical and 93% functional, excellent to good results suggests that stabilizing the fracture fragments with volar plateand screws in the management of the fractures of distal radius, is an effective method to maintain the reduction till union and prevent collapse of the fracture fragments, even when the fracture is grossly comminuted/intra-articular/unstable and/or the bone is osteoporosed. Conclusion: The study emphasizes that open reduction and internal fixation with volar platinghas excellent functional outcomewith minimal complications thus proving that volar plating is the prime modality oftreatment for distal end radius fractures. The procedure is applicable for all types of Frykman fractures in young patients with a good bone stock as well as in elderly osteoporotic patients. Keywords: VolarPlating, Distal Radius Fractures,distal end radius.

Study of outcomes of supracondylar Humerus fracture with ipsilateral lower end radius fracture in children

Study of outcomes of supracondylar Humerus fracture with ipsilateral lower end radius fracture in children

Comparison of outcome of extra articular lower end radius fracture with percutaneous pinning and volar locking plate

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;As fractures of the distal radius are the most common fractures of the upper extremity with no clear guidelines for mode of intervention it was decided to compare two of the most common methods of treatment. The aim of this study was to review a group of patients sustaining extra articular lower end radius fracture treated with percutaneous wiring and volar plating and compare their functional outcome at a significant follow up time.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;A prospective study was conducted at tertiary care center. A sample of 45 patients who had a displaced extra articular distal radius fracture and were subjected to treatment with either a plate (n =24) or k wiring (n =21). Outcome assessments were conducted at 6 months. Outcomes were measured on the basis of scores on the DASH questionnaire, wrist range of motion, and radiographic parameters&lt;/span&gt;.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Patients in the plate group had significantly better DASH scores (p=0.0431) and range of motion at six months compared with patients in the k wiring group. Collapse in radial length was observed in 2 patients with percutaneous wiring which led to suboptimal range of motion and increased DASH scores. Significance arc of motion at 6months in dorsiflexion and palmar flexion were p=0.0038 and when compared with opposite limb were significant in all three planes p=0.0217, p=0.0126 and p=0.0029. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Based on our observation we found that treatment of dorsally displaced, unstable extra articular radius fractures across all age groups, volar-locked plates achieve a superior radiological and functional outcome with minimal complications.&lt;/span&gt;&lt;/p&gt;

Long term outcome of lower end radius fractures treated with locking plates

Introduction: Fractures of distal end radius account for one sixth of all fractures that are seen and treated by orthopaedic surgeons. Increasing functional demand and improved methodologies of achieving and maintaining anatomical reduction, restoration of length, angulation and congruity of joint have generated renewed interest in addressing the anecdotal comments in more precise manner. Plating is a technique to restore and maintain the radial length and prevention of metaphyseal collapse. The focus of our interest in this study is to evaluate the outcome of plating in fractures of lower end of radius. Methods: We reviewed 36 patients treated for distal radius fractures using a plate. All patients were treated by volar plating using Henry’s volar approach for distal radius. Postoperative management included immediate finger movements, limb elevation and wrist immobilization for 4-6 weeks depending on fracture pattern and followed by wrist range of movement physiotherapy. Patients were followed for total 6 months-5 years. Radiographs of wrist joint were taken as well as movements in the form of dorsiflexion, palmerflexion, pronation, supination, radial deviation, ulnar deviation and hand grip were assessed at every follow up for all patients. At every follow up, patients were assessed using Gartland and Werley’s Demerit Scoring System for the result of plating of distal radius fracture. Patients were also evaluated for radiological outcome at immediate postoperative and at final follow up, in the form of radial length, radial inclination and volar tilt. Results: Fracture union had occurred in all patients at the mean time of follow-up of 9.5 weeks. On X-rays taken at the time of follow-up, 31 patients (86.10%) had achieved acceptable radial length that is radial shortening

Clinical Outcome of En-Bloc Resection of Distal Radius Giant Cell Tumor And Reconstruction by Non Ascularized Fibular Graft &amp;Transossious Augmentation of Wrist By PalmarishLongusTendon,An Improvise Technique

Introduction: Giant cell tumor (GCT) of bone is a benign but locally aggressive tumor with tendency for local recurrence. Usually it can be treated by en-bloc resection and reconstruction arthroplasty using autogenous non-vascularizedipsilateral proximal fibular graft. Fibulo-carpal subluxation can be prevent by transossiouspamarishlongus tendon. This improvise technique found useful in preserving the movements and functions as well as stability of the wrist. Materials and Methods: Ten patients with a mean age of 33 years, witheither Campanacci grade II or III histologically proven giant cell tumours of lower end radiuswere treated with wide excision and reconstruction with ipsilateral non-vascularised proximalfibularautograft. Host graft junction was fixed with dynamic compression plate (DCP) in allcases. Wrist ligament reconstruction and fixation of the head of the fibula with carpal bonesand distal end of the ulna using K-wires along with pamarishlongus tendon reinforcement throw transeossiciousroot and primary cancellous iliac crest grafting at grafthost junction was done in all cases. Results: The follow-up ranged from 30 to 60 months (mean,46.8). At last follow-up, the average combined range of motion was 100° with range varyingfrom 60° to 125°. The average union time was 7 months (range, 4 to 12). Non-union occurredin 1 case. Graft resorption occurred in another case. Localised soft tissue recurrence occurredin another case after 3 years and was treated by excision. There was no case of graft fracture,metastasis, death, local recurrence or signifi cant donor site morbidity. A total of 3 secondaryprocedures were required. Conclusions: Enbloc resection of giant cell tumours of the lowerend radius is a widely accepted method. Reconstruction with non-vascularised fibular graft,internal fixation with DCP with primary corticocancellous bone grafting with transfixation of the fibular head and wrist ligament reconstruction minimises the problem and gives satisfactoryfunctional results.

Radiological assessment of age from wrist joint in young adolescents

It's a radiological study of age assessment of 100 cases of young adolescents (Boy = 50; Girl = 50) in the age range of 14-17yrs by taking A-P view X-rays of their right wrist joint including hands. There was not a single case of fusion of lower end of ulna in male under the age of 14yrs. Fusion of lower end of radius is late in both sexes and we don't find any fusion in boys up to the 16yrs of age. It was observed that there is considerable narrowing of the range of radiological age assessed using the x-ray of the hand, from 15 years-19 years to 14 years-17 years in both boys and girls. The present study emphatically reveals that an adolescent either boy or girl whose secondary ossification centres of base of first metacarpal, heads of second, third, fourth and fifth metacarpals, bases of phalanges have fused could have attained the age of 17 years. This finding is quite reasonably consistent with the age from the available date of birth certificates of these students.

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

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

A Study of Fractures of Lower End of Radius in Different Ages

80(eighty) patients of both sexes of different age groups are selected for study radiologically 37 males (40.25%) and 43 females (53.75%). The age group is 20 to 60 years.21–30 years of age are 8.75%, 31–40 are 32.5%, 41–50 are 25%, 51–60 are 18% and 61–70 are 15%. Right handed fractures are 53.7%, and left handed fractures are 46.2%. and mode of fractures injury are, fall on out stretched hand 21.25%., fall from height 61.25% traffic accidents are 11.25%, direct blow on wrist are 6.2%,. The fractures are classified as per Cooneys classification which is accepted globally, Type-18.7% type-2-.23.7%, type 3–8.7%, type 4–48.75. Majority of fractures are displaced.such studies are also reported by previous workers. This will certainly help the radiologist and orthopedician to correlate the types of fractures and different age groups.moreover this study will ease the orthopedician predict the period of healing the fractures and prevent the post surgical complications