*Corresponding author:Dr Mohit J Jain, Department and hospital of author: Department and hospital of author: Assistant Professor, Department of Orthopaedic, Pravara Institute of Medical Sciences and Rural Medical College, Loni, India; Affiliated Institution: Sanjeevani Multispeciality Hospital, Jetpur, India, Tel: +919879105944; Email: email@example.com
Received: November 29, 2017; Published: December 12, 2017
To view the Full Article Peer-reviewed Article PDF
Introduction: Operative fixation of distal radius fractures is one of the most commonly performed orthopedic procedures. Though external fixator is a well-established method of treatment for unstable and comminuted fractures, orthopedic surgeons from rural areas of developing countries are still found to be hesitant to use it for various reasons. Aim of our study is to provide an alternate technique for currently used external fixator or distracter modules in limited resources and not to substitute them.
Methods: A total of 32 elder patients with distal radius fractures from a rural hospital were treated with a Non-Spanning Syringe Fixator at a rural hospital which incorporates percutaneous K-wires used to fix distal radius fractures after anatomical reduction. These patients were evaluated for clinical and radiographic outcomes for 1 year and compared with a historical control group of 30 patients with Hoffman II external fixator construct by the same author but at the tertiary center.VAS and DASH scores comparison was also done. Our study results have also been compared with various other known case series for treatment of fracture distal radius by Gartland and Werley score.
Results: Mean radial tilt, 4 degrees; ulnar variance 0 mm and radial inclination angle was 23 degrees at 1 year final follow up. Mean loss of wrist range of motion as compared to normal side was as follows: flexion, 8 degrees, extension, 9 degrees; radial deviation, -1 degrees; ulnar deviation, 2 degrees ; pronation, -1 degrees ; and supination, 8 degrees. Average final DASH score was 9 ranging from 3-14.No statistically significant difference found in radiological and clinical variables or DASH scores between control Hoffman II fixator group and study group of Non Spanning Syringe Distractor. Using the Gartland and Werley score, there were 24 (80%) excellent to good and 6 (20%) fair to poor results which are quite comparable to other landmark studies.
Conclusion: External fixation has advantages over conventional Plaster of Paris cast and pinning in the treatment of unstable extraarticular or simple intra-articular fractures of distal radius. Non Spanning Syringe Distractor provides excellent to good results in majority of our cases. It provides advantages of pinning and fixator both by preventing wrist and hand stiffness and fracture collapse as well. The Simplicity of technique, less operative time, possible in minimal regional anesthesia and cost effectiveness all together makes it very useful for limited resources scenario.
Keywords: Distal Radius Fractures; Hoffman II External Fixator; Non-Spanning Syringe Distractor