Archives of Orthopaedic and Trauma Surgery

, Volume 133, Issue 5, pp 595–602 | Cite as

Non-bridging external fixation employing multiplanar K-wires versus volar locked plating for dorsally displaced fractures of the distal radius

  • Georg Gradl
  • Gertraud Gradl
  • Martina Wendt
  • Thomas Mittlmeier
  • Guenther Kundt
  • Jesse B. Jupiter
Orthopaedic Surgery



The aim of this study was to compare non-bridging external fixation to palmar angular stable plating with respect to radiological outcome, wrist function, and quality of life.


One hundred and two consecutive patients (mean age: 63 years) were enrolled in the study. Fifty-two patients were randomized for plate osteosynthesis (2.4 mm, Synthes), 50 patients received non-bridging external fixation (AO small fixator). Objective (range of motion, grip strength), patient rated outcomes (quality of life, pain), and radiological outcome were assessed 8 weeks, 6 months, and 1 year after surgery.


Loss of radial length of more than 3 mm was not detected in any group. Volar tilt was better restored by external fixation (7.2°) than by volar plating (0.1°). Wrist function was good in both groups. The external fixator was tolerated very well, and the quality of life assessment revealed comparable results in both groups. Osteoporosis was found in 54 % of patients and had no influence on radiological and functional outcome.


Non-bridging external fixation employing multiplanar K-wires is a suitable treatment option in intra- and extra-articular fractures of the distal radius even in osteoporotic bone.

Level of evidence

Prospective randomized trial, Level I.


Distal radius fracture External fixation Non-bridging Functional outcome Volar plating 



The study was supported by a grant from the AO.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Georg Gradl
    • 1
  • Gertraud Gradl
    • 3
    • 4
  • Martina Wendt
    • 1
  • Thomas Mittlmeier
    • 1
  • Guenther Kundt
    • 2
  • Jesse B. Jupiter
    • 3
  1. 1.Department of Trauma and Reconstructive SurgerySurgical Clinic University of RostockRostockGermany
  2. 2.Department of Medical Informatics and BiometryUniversity of RostockRostockGermany
  3. 3.Hand and Upper Extremity Service, Department of Orthopaedic SurgeryMassachussetts General HospitalBostonUSA
  4. 4.Department of Trauma and Reconstructive SurgeryUniversity of AachenAachenGermany

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