Management of Unstable Pediatric Distal Radius Fractures With a 2-Pin External Fixator and a Short Arm Cast: Technique and Case Series

Pediatric distal radius fractures that are unacceptably aligned and undergo closed reduction are often redisplaced when immobilized in a cast alone without additional fixation. Percutaneous pinning, plate and screw fixation, and 4-pin wrist joint and physis-spanning external fixation constructs have previously been described to achieve and maintain reduction. We successfully treated and followed 12 consecutive pediatric patients presenting with malaligned, nonphyseal distal radius fractures that were reduced and held with a 2-pin external fixation construct that did not extend distal to the physis, supplemented by a short arm cast. No complications were encountered in this series of patients. Two-pin external fixation is an alternative solution for completely displaced or markedly angulated pediatric distal radius fractures.