A new procedure for unstable fractures of the distal radius is presented. It uses a nonbridging external fixator in conjunction with calcium phosphate bone cement through a limited exposure. The best indication for the new procedure is intra-articular fracture with some large displaced fragments in young adults. In the C2 or C3 type fractures according to AO classification, it is very difficult to obtain satisfactory fixation with a plate and screws due to comminution of the articular surface and metaphysical bone defects in many instances. After reduction of the articular surface, this new technique allows fixation of the comminuted fragments using half pins of a nonbridging external fixator. Furthermore, injection of calcium phosphate bone to the bone defect helps to make both the articular surface and the cortical bone stable. The nonbridging external fixator allows early exercises. However, it cannot be applied to all types of the fracture because of its structural limitations. The combination of nonbridging external fixation and calcium phosphate bone applications assures early exercise of the wrist.
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http://dx.doi.org/10.1097/01.bth.0000129886.85827.31 | DOI Listing |
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