Ilizarov hybrid external fixation for fractures of the distal radius: PartI. Feasibility of transfixion wire placement

The advantages of Ilizarov external fixation, allowing early motion of adja cent joints during fixation of periarticular fractures, have not yet been a pplied to distal radius fractures. A magnetic resonance imaging study of 10 normal volunteers evaluated the safety of passing percutaneous transfixion pins across the distal radius in 3 forearm positions. Even in the optimal forearm position, the safe zones between the transfixion pin, vessel, nerve , or tendon was small, suggesting that open placement would be required. A cadaver study in 8 specimens demonstrated that the pins could be placed wit h an open technique using an aiming device and that the pins could be place d without limiting forearm rotation. The proximity of vital structures to t ransfixion pins dictates open placement to safely apply Ilizarov fixation t o distal radius fractures. (J Hand Surg 2001;26A:210-217. Copyright (C) 200 1 by the American Society for Surgery of the Hand.).