ORIGINAL ARTICLE   

Minerva Orthopedics 2024 December;75(6):436-44

DOI: 10.23736/S2784-8469.24.04439-0

Copyright © 2024 EDIZIONI MINERVA MEDICA

lingua: Inglese

External fixation system is a valid treatment choice in distal radius fractures: clinical and radiological follow-up of 22 cases

Norman DELLA ROSA ¹, Andrea MANFREDI ² ✉, Davide GRAVINA ¹, Francesco CASELGRANDI ³, Roberto ADANI ¹

¹ Hand and Microsurgery Unit, AOU Modena, Modena, Italy; ² Orthopedic and Traumatology Unit, AOU Modena, Modena, Italy; ³ Hand Rehabilitation Unit, AOU Modena, Modena, Italy

BACKGROUND: Distal radius fractures are common condition, with an estimated incidence of 643,000 cases each year in the USA. These fractures are a major burden on the healthcare system (HS) (535 million per year). The optimal method of fixation remains a topic of debate. The most common treatment is open reduction with internal fixation (ORIF) with volar plate. The aim of this study is to show how external fixator could be a valid alternative to ORIF for treatment of different types of distal radius fractures in patients with variable functional request.
METHODS: We realized a retrospective observational study of 22 patients, average age of 56 (23 to 88) years, 36% male (8/22) and 63.64% female (14/22), with distal radius fractures treated with external fixator have been evaluated. The study evaluated motion, limitations in daily activities and strength at 3 and 6 months after surgery.
RESULTS: Fractures 23A-B-C (AO/OTA classification) have been evaluated. An average flexion of 66.77°, extension of 75°, pronation of 89.09° and supination of 89.23° have been observed. The Disability of the Arm, Shoulder and Hand value (DASH) and Patient Rated Wrist/Hand Evaluation value (PRWHE) scores both averaged 16% at the 6-month follow-up. Jamar Hydraulic Hand Dynamometer (JD) test showed results of 3.15±0.63 kg. The radiological reduction has been achieved.
CONCLUSIONS: Good clinics outcomes have been recorded; external fixator remains an excellent alternative to plate. Cost is lower for healthcare system. The advantages are early mobilization and low local invasiveness.

KEY WORDS: Radius fracture; External fixators; Orthopedic procedures; Wrist