Dynamic external fixation for comminuted intra-articular fractures of the distal end of the radius.

An external fixation device that allows motion of the wrist was developed for the treatment of severely comminuted intra-articular fractures of the distal end of the radius, and in specimens from cadavera that motion was demonstrated with the device in place. Thirty patients who had thirty-two comminuted intra-articular radial fractures were then treated with fixation using this device during a six-month interval. Thirty-one of the wrists were examined at follow-up one and two years later. The first fifteen wrists that were allowed full flexion and extension immediately postoperatively had lost some volar tilt postoperatively. The other patients, for whom only flexion was allowed immediately postoperatively, while extension was allowed four weeks later, did not lose volar tilt. The device maintained the reduction of the fracture fragments and allowed the early return of a functional range of motion of the wrist.