A Study On Dynamic Vs Static External Fixation Of Distal End Of Radius Fractures.

[摘要] Distal radius fractures may be managed non-operatively or operatively with both methods resulting in goodreliable results when appropriately used.The operative methods for displaced unstable fractures include closedreduction with percutaneous pinning, open reduction with internal fixation, external fixation, combinations ofpercutaneous pinning with internal and external fixation, arthroscopically assisted reduction and bone grafting andcementing techniques. External fixation of distal radius fractures may be static or dynamic. Static fixation involves awrist-bridging (WB) external fixator with no possibility of wrist mobilisation during the treatment period. Dynamicfixation allows wrist mobilisation whilst the fixator is in place. This may be achieved with a WB fixator with a mobilehinge joint or by a non-bridging (NB) fixator with pins being inserted into the distal end of the radius. To analyse andcompare functional and anatomical outcomes of management of displaced, unstable and comminuted fractures of theDistal Radius and early wrist mobilization in adult patients with dynamic multiplanar external fixation (Penning-typefixator) against those of patients managed with static monoplanar fixation. This study was conducted in the year2021 augustDepartment of orthopedics, Government Nagapattinam Medical College& Hospital, Nagapattinam, TamilNadu, India. About 23 patients with intraarticular distal radius fractures were selected and treated with dynamicexternal fixator with or without supplementary techniques. 3 patients had lost follow up and so 20 patients wereanalysed in the study. Average follow up is 12.84 months. The results were analysed as functional outcome usingGreen and O’Brien score (modified by Cooney et al) and anatomical outcome using Lidstrom score. After properanalysis and doing statistical comparison, we got p- value of 0.159 for anatomical outcome which is statisticallyinsignificant and 0.046 for functional outcome which is statistically significant. (Significance of p value determined as<0.05). With regard to individual parameters in the scores, we got significantly better results in the values of range ofmotion in dynamic group and less reduction in radial length in static group. 3 patients had superficial infection and 1patient had secondary arthritis in dynamic group and 2 patients had superficial infection ,2 patients had secondaryarthritis and 1 patient had deep infection in static group. We concluded that there are no major differences in theanatomical outcome of both the techniques in terms of volar tilt, radial length and radial inclination in treatingcomminuted distal radius fractures. Even though there is no statistical difference in the anatomical outcome,dynamic external fixation plays a better role than static external fixation in functional parameters like range of motion,early return to work due to early wrist mobilisation.

[学科分类] 工程和技术（综合）

[关键词] Distal radius fractures;dynamic external fixator;static external fixator;multiplanar ligamentotaxis;uniplanar ligamentotaxis.