RECURRENT DORSAL ANGULATION OF THE DISTAL RADIUS FRACTURE DURING DYNAMIC EXTERNAL FIXATION

Thirty-three fractures of the distal radius treated with a dynamic ext ernal fixator (that allowed for wrist motion between 2 to 4 weeks afte r surgery) were analyzed, focusing on loss of fracture reduction durin g external fixation. Fractures with preoperative dorsal angulation gre ater than 20 degrees and those involving the distal radioulnar joint h ad a significantly larger loss of reduction of dorsal angulation (8.9 degrees and 6.9 degrees, respectively) than fractures with less severe preoperative dorsal angulation or those with an intact distal radioul nar joint (3.0 degrees and 2.6 degrees, respectively). In contrast, pr eoperative radial shortening (>2 mm) and involvement of the radiocarpa l joint did not significantly increase the loss of dorsal angulation. Neither of the 2 dynamic external fixation systems studied consistentl y stabilized Colles' fractures with preoperative dorsal angulation of greater than 20 degrees or involvement of the distal radioulnar joint. Copyright (C) 1998 by the American Society for Surgery of the Hand.