TREATMENT OF COMMINUTED DISTAL RADIUS FRACTURES - AN APPROACH BASED ON PATHOMECHANICS

Following dorsally displaced fractures of the distal radius, the class ic position of immobilization is with the wrist flexed and in ulnar de viation. This is not the position of function and entails morbidity in the form of finger stiffness, which may require prolonged rehabilitat ion. We treated 20 consecutive, comminuted, intraarticular distal radi al fractures using a new external fixation system with the wrist in a neutral to extended position, thereby promoting metacarpophalangeal jo int flexion by relatively relaxing the finger extensor tendons. Supple mental pin fixation was used in eight cases. Most patients were perfor ming active digital motion on the day of surgery and 95% maintained fu nctional finger motion during treatment. All fractures healed uneventf ully. Palmar tilt was restored in 55% of patients in spite of a wrist neutral or extended position. This method of fixing distal radial frac tures allows restoration of anatomy while avoiding hand stiffness.