Skip to main content

Combined External Fixation and Internal Fixation

  • Chapter
  • First Online:
Distal Radius Fractures
  • 1893 Accesses

Abstract

Fractures with severe comminution of the joint surface and with little metaphyseal support to the volar rim fragments may benefit from a volar buttress plate in addition to ligamentotaxis served by an external fixator. The most severe, comminuted fractures however should be subject to augmented external fixation. If a CT-scan reveals bone fragments of a size that can be captured by (multidirectional) screws, plate fixation is an alternative. If not, these fragments may be fixated by K-wires through an open approach, or simply left in place. The documentation is poor, but the combination of plate fixation and external fixator can produce a satisfactory outcome in the most comminuted fractures. Given the possible, combined complications of the two methods, it should be an option only when adequate reduction and stability cannot be achieved by one method alone.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21(5):316–22.

    Article  PubMed  Google Scholar 

  • Bass RL, Blair WF, Hubbard PP. Results of combined internal and external fixation for the treatment of severe AO-C3 fractures of the distal radius. J Hand Surg Am. 1995;20(3):373–81.

    Article  CAS  PubMed  Google Scholar 

  • Cooney WP, Berger RA. Treatment of complex fractures of the distal radius. Combined use of internal and external fixation and arthroscopic reduction. Hand Clin. 1993;9(4):603–12.

    CAS  PubMed  Google Scholar 

  • 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. 2005;87B:829–36.

    Article  Google Scholar 

  • Margaliot Z, Haase SC, Kotsis SV, Kim HM, Chung KC. A meta-analysis of outcomes of external fixation versus plate osteosynthesis for unstable distal radius fractures. J Hand Surg Am. 2005;30(6):1185–99.

    Article  PubMed  Google Scholar 

  • McAuliffe JA. Combined internal and external fixation of distal radius fractures. Hand Clin. 2005;21(3):395–406.

    Article  PubMed  Google Scholar 

  • Osada D, Viegas SF, Shah MA, Morris RP, Patterson RM. Comparison of different distal radius dorsal and volar fracture fixation plates: a biomechanical study. J Hand Surg. 2003;28A:94–104.

    Article  Google Scholar 

  • Orbay JL, Fernandez DL. Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg Am. 2004;29(1):96–102.

    Article  PubMed  Google Scholar 

  • Rogachefsky RA, Lipson SR, Applegate B, Ouellette EA, Savenor AM, McAuliffe JA. Treatment of severely comminuted intra-articular fractures of the distal end of the radius by open reduction and combined internal and external fixation. J Bone Joint Surg Am. 2001;83-A(4):509–19.

    CAS  PubMed  Google Scholar 

  • Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am. 2006;31(3):359–65.

    Article  PubMed  Google Scholar 

  • Short WH, Palmer AK, Werner FW, Murphy DJ. A biomechanical study of distal radial fractures. J Hand Surg. 1987;12A:529–34.

    Article  Google Scholar 

  • Slutsky DJ. External fixation of distal radius fractures. Hand Surg. 2007;32A:1624–37.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ola-Lars Hammer MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hammer, OL. (2014). Combined External Fixation and Internal Fixation. In: Hove, L., Lindau, T., Hølmer, P. (eds) Distal Radius Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54604-4_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54604-4_21

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54603-7

  • Online ISBN: 978-3-642-54604-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics