Abstract
Distal radius fractures are the second most common fracture seen in the Emergency Department. Many patients may be treated nonoperatively, with closed reduction and immobilization. For those patients in whom satisfactory reduction cannot be achieved, a number of surgical options exist. External fixation is a valuable and effective option in certain patients. Specific indications include: intra- and extra-articular dorsally angulated fractures that fail closed reduction, severely comminuted fractures, open fractures, and fracture-dislocations of the wrist. Favorable outcomes have been reported. Specifically, percutaneous pinning in addition to external fixation yields better outcomes than fixation alone. Several studies comparing external fixation and volar plating have shown no significant differences in pain, grip strength, or range of motion. Technical pearls and pitfalls are described here, as proper technique and consideration of the principles of external fixation are necessary.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Cooney 3rd WP, Linscheid RL, Dobyns JH. External pin fixation for unstable Colles’ fractures. J Bone Joint Surg Am. 1979;61(6A):840–5.
Leung KS, Shen WY, Tsang HK, et al. An effective treatment of comminuted fractures of the distal radius. J Hand Surg [Am]. 1990;15(1):11–7.
Cannegieter DM, Juttmann JW. Cancellous grafting and external fixation for unstable Colles’ fractures. J Bone Joint Surg Br. 1997;79(3):428–32.
Fernandez DL, Geissler WB. Treatment of displaced articular fractures of the radius. J Hand Surg [Am]. 1991;16(3):375–84.
Trumble TE, Wagner W, Hanel DP, et al. Intrafocal (Kapandji) pinning of distal radius fractures with and without external fixation. J Hand Surg [Am]. 1998;23(3):381–94.
Lin C, Sun JS, Hou SM. External fixation with or without supplementary intramedullary Kirschner wires in the treatment of distal radial fractures. Can J Surg. 2004;47(6):431–7.
Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg [Am]. 2005;30(2):289–99.
Rizzo M, Carothers JT, Kaat BA. Comparison of locked volar plating versus pinning and external fixation in the treatment of unstable intraarticular distal radius fractures. Hand. 2008;3(2):111–7.
Egol K, Walsh M, Tejwani N, et al. Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. J Bone Joint Surg. 2008;90(9):1214–21.
Kreder HJ, Hanel DP, Agel J, et al. Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomised, controlled trial. J Bone Joint Surg Br. 2005;87(6):829–36.
Rozental TD, Blazar PE, Franko OI, et al. Functional outcomes for unstable distal radial fractures treated with open reduction and internal fixation or closed reduction and percutaneous fixation. A prospective randomized trial. J Bone Joint Surg Am. 2009;91(8):1837–46.
Sanders RA, Keppel FL, Waldrop JI. External fixation of distal radial fractures: results and complications. J Hand Surg [Am]. 1991;16(3):385–91.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Lewallen, L.W., Rizzo, M. (2016). External Fixation and Percutaneous Pinning for Distal Radius Fractures. In: Lawton, J. (eds) Distal Radius Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-27489-8_12
Download citation
DOI: https://doi.org/10.1007/978-3-319-27489-8_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-27487-4
Online ISBN: 978-3-319-27489-8
eBook Packages: MedicineMedicine (R0)