External Fixation for Distal Radius Fractures - David Houlihan-Burne 28/11/2000
BACKGROUND
Change from 'pins and plaster' to external fixation in early 1980's. Principles of ligamentotaxis understood. Initially trans-articular static fixators. More modern designs include trans-articular hinge design and peri-articular (extra-articular).
Indications for external fixation - 3 or more cortices with comminution in conjunction with shortening (> 5mm) and / or intra-articular involvement in radiocarpal or radioulnar joint.
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Authors
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Jenkins NH, Jones DG, Johnson SR, Mintowt-Czyz WJ
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External Fixation of Colles Fractures
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Reference
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J Bone Joint Surg [Br] 1987 : 69 - B : 207 - 210
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Summary
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PRCT. 58 pts < 60.Displaced Colles' #. Randomised (MUA + POP or Periarticular XFIX).16 / 52 radiographic F/U. Re-manipulations excluded. XFIX maintained 'excellent' posn. Only one POP case maintained position. Recommend extra-articular XFIX as best way of maintaining reduction
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Critique
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Anatomical (radiographic) study, no functional correlation. Extra-articular # only
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Authors
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Jenkins NH, Jones DG, Mintowt-Czyz WJ
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External Fixation and Recovery of Function Following Fractures of the Distal radius in Young Adults
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Reference
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Injury (1988) 19 : 235-238
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Summary
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PRCT. 106 pts < 60 yo with Colles fracture randomised (Extra-articular XFIX or MUA + POP) 1yr F/U. Anatomical assessment - XFIX better at maintaining position. Functional assessment - Equal in first 3/12. At 1 yr equal ROM but XFIX pts greater grip strength. Wrist immobilisation does not retard early recovery but improves long term function by virtue of improved anatomical result.
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Critique
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Heterogenous gp of # (intra + extra-articular)
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