Dynamic external fixation of unstable fractures of the distal part of the radius. A prospective, randomized comparison with static external fixation

T. G. Sommerkamp, M. Seeman, J. Silliman, A. Jones, S. Patterson, J. Walker, M. Semmler, R. Browne, M. Ezaki

Research output: Contribution to journalArticle

100 Scopus citations

Abstract

A prospective, randomized study was done to compare the results of dynamic external fixation (the Clyburn device) with those of static external fixation (the AO/ASIF device) in the treatment of fifty unstable fractures of the distal part of the radius. Mobilization of the wrist from neutral to 30 degrees of flexion was begun in the dynamic-fixator group at approximately two weeks, and full motion, allowing 30 degrees of extension, was started at approximately four weeks. The external fixation frames in both groups were kept in place for approximately ten weeks. Mobilization of the wrist in the dynamic-fixator group provided little gain in the mean motion of the wrist at the time of the removal of the fixator or at the one, six, or twelve-month evaluation. The static-fixator group had greater flexion of the wrist and radial deviation at the early and late follow-up examinations, while the dynamic-fixator group demonstrated only greater ulnar deviation one month after the fixator had been removed. Motion of the wrist in the dynamic- fixator group resulted in a statistically significant loss of radial length compared with that in the static-fixator group (four millimeters compared with one millimeter, p < 0.001). Complications were more frequent in the dynamic-fixator group. As evaluated with a modification of the scoring system of Gartland and Werley, 92 per cent of the results at one year were excellent or good in the static-fixator group and 76 per cent, in the dynamic-fixator group. The results of this study cannot support the concept of early mobilization with a dynamic external fixator for the treatment of unstable fractures of the distal part of the radius.

Original languageEnglish (US)
Pages (from-to)1149-1161
Number of pages13
JournalJournal of Bone and Joint Surgery - Series A
Volume76
Issue number8
DOIs
StatePublished - Jan 1 1994

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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