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Indian Journal of Orthopaedics Surgery


“A study of management of intra-articular fractures of distal end radius by external fixator”


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Author Details: Devendrappa H, Shiva Naik R, Guruduth GV, Rohit R

Volume : 2

Issue : 3

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 246

Article End Page : 253


Abstract

A fracture of the distal radius is one of the commonest skeletal injuries treated by the orthopaedic surgeon. Thirty to forty years ago the distal radial fractures were considered benign and conservative treatment was the rule. Pain and disability have resulted from subsequent mal-unions of fractures of distal radius, which were managed by conservative methods like plaster cast alone. Recently surgical treatment has been widely recommended and performed to prevent sequelae of mal-union, like pain and disability. There were 16 male and 4 female patients, between the age group of 23 to 50 years with an average age of 38.2 years. The injury occurred due to low energy trauma like, fall on outstretched hand in 8 patients. In 12 (60%) patient’s injury occurred due to high velocity trauma like road traffic accidents (in 10) and fall from height. The dominant (right hand) was affected in 9 cases (45%) and left hand in 11 cases. Five patients had associated fractures and injuries; like, head injury and clavicle injury in one patient, ipsilateral Monteggia fracture-dislocation in another patient, the third patient had fracture L3 vertebra without neurological deficit, the fourth patient had contra lateral inter-trochanteric fracture and the fifth one had clavicle fracture. Two patients had bilateral intra-articular fractures but only right side was considered for the study. Three patients had open fractures, Grade I in one patient and Grade II (Gustilo and Anderson) in two patients. One patient had allergic dermatitis over left hand and forearm, which was treated by the dermatologist and then was operated. Pre-operative evaluation of all the patients and the fractures was done by clinical and radiological examination by taking X-rays of wrist in both antero-posterior and lateral views. The fracture fragments were analyzed, involvement of radiocarpal, radioulnar joints were assessed and were classified according to the Frykman’s Classification of fractures of distal end of radius. There were 2 cases of Type III, 1 case of Type IV, 3 cases of Type VI, 9 cases of Type VII and 5 cases of Type VIII. Most of the fractures (70%) belonged to Type VII and Type VIII.