H. Sakano et al., Treatment of the unstable distal radius fracture with external fixation and a hydroxyapatite spacer, J HAND S-AM, 26A(5), 2001, pp. 923-930
A prospective study was performed on 25 patients (15 women, 10 men) with un
stable fractures of the distal radius selectively treated with a dynamic ty
pe of external fixation combined with a hydroxyapatite spacer. The fracture
s ranged from type VI to type VIII according to Frykman's classification. T
he patients' mean age at surgery was 49 years (range, 19-75 years). The mea
n follow-up period was 2.5 years, and overall outcome was assessed using Ga
rtland and Werley's demerit point system as modified by Sarmiento. Radial i
nclination was 26 degrees +/- 4 degrees at the time of reduction and 26 deg
rees +/- 5 degrees at follow-up, palmar tilt was 9 degrees +/- 2 degrees at
reduction and 8 degrees +/- 3 degrees at follow-up, and ulnar variance was
1.4 +/- 0.6 mm at reduction and 2.1 +/- 0.9 mm at follow-up. The mean rang
e of motion at follow-up was 80 degrees +/- 10 degrees in flexion, 80 degre
es +/- 10 degrees in extension, 85 degrees +/- 10 degrees in supination, an
d 80 degrees +/- 5 degrees in pronation. The outcome in 24 of 25 patients w
as evaluated as excellent. In the surgical treatment of unstable fractures
of the distal radius using external fixator, the fracture reduction should
be supported with bone graft or a bone substitute, and a hydroxyapatite spa
cer was considered to be a useful substitute for a bone graft. Copyright (C
) 2001 by the American Society for Surgery of the Hand.