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 retrospective study. SETTING The orthopedic department of National Taiwan University Hospital. PATIENTS Eighty-five consecutive patients (36 female, 49 male), average age 48 years, with fractures of the distal radius seen between March 1995 and June 1998. INTERVENTIONS Closed reduction and external fixation of fractures, followed up by good-quality posteroanterior and lateral radiographs to evaluate healing. MAIN OUTCOME MEASURES Radial height, radial inclination and volar tilt were measured on radiographs obtained initially, immediately postoperatively and at the time of removal of external fixation. Data were analyzed by the t-test. RESULTS Immediately after reduction and fixation, there was a significant improvement in the measurements of radial height and radial inclination. This improvement was gradually lost and height and inclination were significantly decreased at the time the external fixation device was removed. External fixation did not improve the volar tilt. CONCLUSION External fixation is a popular method to improve the reduction of osseous deformity but cannot effectively protect comminuted distal radial fractures from loss of reduction, which may be associated with shortening and redisplacement.