Surgical outcome of distal end radius fractures by ligamentotaxis

Abstract

BACKGROUND AND OBJECTIVES: Preservation of the articular congruity is the principle prerequisite for successful recovery, following distal radius fractures. The best method of obtaining and maintaining an accurate restoration of articular anatomy, however, remains a topic of considerable controversy. The main aim of this study is to evaluate the results obtained by treatment of distal end radius fractures by external fixation. MATERIALS AND METHODS: This is a prospective controlled study; fifty cases of unstable distal end radius fractures with/without intra-articular extension were treated with uniplanar static type of external fixation using the principle of ligamentotaxis and augmentation by K-wires from July 2013 to December 2016 at our tertiary rural hospital. The age group of the patients is 18–60 years, external fixator was applied for a duration of 6–8 weeks, and cases were followed up for an average of 6–10 months postoperatively. RESULTS: Assessed as per Demerit Point System of Gartland and Werley (modified by Sarmiento 1975) for functional results and criteria for anatomical results by Sarmiento (1975) at the end of 6–8 months of follow-up. Excellent anatomical result was seen in 11 patients, good result seen in 32 patients, and fair result seen in five patients with two poor result patients. CONCLUSION: External fixation and ligamentotaxis provide better functional and anatomical results in comminuted intra-articular and unstable extra-articular wrist injuries. The functional result of treatment of distal radius fractures not only depends on the anatomical restoration of the articular surface but also depends on the associated soft tissue injuries and articular damage.