Use of the Hoffman 2 compact external fixator in the treatment of redisplaced unstable distal radial fractures.

The aim of this study was to examine the use of a new joint sparing external fixation device for unstable redisplaced fractures of the distal radius. Participants were twenty consecutive patients with unstable redisplaced fractures of the distal radius with sufficient space in the distal fragment to allow use of a nonbridging technique. The patients had to be capable of cooperating with functional outcome measures. All patients underwent closed nonbridging external fixation of the distal radius using the Hoffman 2 compact external fixator. The main outcome measures were radiological determinations of dorsal angle, radial shortening, and carpal alignment; measurements of mass grip strength and range of movement; and rate of complications. Volar tilt was successfully regained and maintained (mean 4 degrees) at final review. Radial shortening was a mean of one millimeter at final review. Nineteen of twenty patients regained normal carpal alignment. Grip strength returned to a mean of 74 percent of the opposite (normal) side in the whole group and 88 percent in those who completed review for the longest periods. Ranges of movement were restored to around 80 percent, except flexion (66 percent). The rate of major complications was 15 percent. We conclude that nonbridging external fixation using the Hoffman 2 compact device reliably restores and maintains volar tilt and radial length after re-reduction of unstable fractures of the distal radius. Functional outcome and complications are comparable with findings in previous reports.