SURGICAL OPTIONS FOR DISTAL RADIAL FRACTURES - INDICATIONS AND LIMITATIONS

Distal radial fractures Lire common problems for the orthopedic surgeo n, and various surgical treatments have been reported. However, each m ethod has its indications, pitfalls, and limitations. it is important ta select the appropriate procedure fur the fracture pattern. We studi ed IIS consecutive patients including 45 patients with distal radial f ractures treated with percutaneous pinning, 67 patients treated with e xternal fixation, and 32 patients treated with assisted wrist arthrosc opy. Percutaneous pinning was useful in extra-articular fractures and minimally comminuted intra-articular fractures, but was inadequate for patients with severe osteopenia and markedly comminuted intra-articul ar fractures. External fixation was indicated when intra-articular com minution was present. However, the dorsomedial fragment was often not reduced and maintained by this technique: additional pinning was neede d to reduce this fragment, A dynamic-type fixator was feasible for you nger patients who required early functional recovery, Arthroscopy prov ided accurate visualization of the wrist joint and the intra-articular fracture.