Extra-articular deformity in distal radial fractures treated by external fixation

Objective: To determine the radiographic outcome in fractures of the distal radius treated with closed reduction and external fixation. Design: A retr ospective study. Setting: The orthopedic department of National Taiwan Univ ersity Hospital. Patients: Eighty-five consecutive patients (36 female, 49 male), average age 48 years, with fractures of the distal radius seen betwe en March 1995 and June 1998. Interventions: Closed reduction and external f ixation of fractures, followed up by good-quality posteroanterior and later al radiographs to evaluate healing. Main outcome measures: Radial height, r adial inclination and volar tilt were measured on radiographs obtained init ially, immediately postoperatively and at the time of removal of external f ixation. Data were analyzed by the t-test. Results: Immediately after reduc tion and fixation, there was a significant improvement in the measurements of radial height and radial inclination. This improvement was gradually los t and height and inclination were significantly decreased at the time the e xternal fixation device was removed. External fixation did not improve the volar tilt. Conclusion: External fixation is a popular method to improve th e reduction of osseous deformity but cannot effectively protect comminuted distal radial fractures from loss of reduction, which may be associated wit h shortening and redisplacement.