External fixation for distal radius fractures: Effect of distraction on outcome

Few studies have examined the potential adverse effects of excess distracti on and prolonged duration of external fixation for the treatment of distal radius fractures. In this study, 19 patients with distal radius fractures t reated with external fixation and supplemental Kirschner wire fixation betw een August 1991 and November 1997 were studied retrospectively. Patients we re evaluated by questionnaire, chart review, radiographs, and clinical exam ination an average of 161 weeks after injury. Although no significant corre lation was found between amount of distraction, as measured by carpal heigh t index, and scores for pain, function, radiographs, motion, grip, strength , and final result, a negative correlation was found of all categories with increasing carpal height index. A significant negative correlation was see n between duration of external fixation and scores for pain, motion, and to tal score, with motion scores being most affected, New York Orthopaedic Hos pital grades of good or excellent were attained by 89% of the patients. The data suggest that external fixation with supplemental pin fixation is a sa tisfactory method of treating severe fractures of the distal radius. Outcom e likely is improved with shorter duration of external fixation.