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Efficacy of an External Fixator in Treating Intra-Articular Fractures of the Distal Radius

Yıl 2026, Cilt: 9 Sayı: 1, 120 - 125, 17.03.2026
https://izlik.org/JA37AY67ZR

Öz

Aim: Distal radius fractures are among the most common injuries in daily practice. The medical community continues to debate the best treatment methods for joint surface involvement in this condition. This study investigated how closed reduction with external fixator treatment benefits patients who have intra-articular distal radius fractures.
Methods: Between January 2021 and December 2022, 53 patients treated in our clinic were retrospectively analyzed. Uniplanar radiocarpal external fixator was applied to all patients after closed reduction. The fractures were grouped as C1, C2, and C3 according to the AO/OTA classification. Radial inclination, volar tilt, radial height, ulnar variance, and articular digit were measured in the radiological evaluation. Functional outcomes were evaluated using modified Gartland-Werley scoring, and radiological results were evaluated using Sarmiento criteria. Pain was monitored with VAS scale and upper extremity function with DASH score. The patients were followed for a mean of 16 months.
Results: The mean age of the patients was 48.6 years and the majority of them were female. Significant improvement was observed in all postoperative radiological parameters (p<0.001). At the last check, the VAS score decreased from 7.2 to 1.5 and the DASH score decreased from 48.6 to 12.2. Grip strength reached 93.8% of the healthy side. Functionally, 54.7% of the patients had good or very good results. Outcomes worsened as fracture complexity increased (p<0.05). The complication rate was determined as 30.2%.
Conclusion: External fixation serves as a suitable treatment method which provides satisfactory results in both radiographic evaluations and patient function for patients who have intra-articular distal radius fractures.

Kaynakça

  • Gouk C, Ng SK, Knight M, Bindra R, Thomas M. Long term outcomes of open reduction internal fixation versus external fixation of distal radius fractures: A meta-analysis. Orthop Rev (Pavia). 2019;11(3):7809. Crossref
  • Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC. A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg Am. 2011;36(5):824-835. Crossref
  • Zahed M, Elmesalmi M, El Menawy Z, et al. Volar Locking Plate Versus External Fixation for Distal Radius Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus. 2026;18(1):e100789. Crossref
  • Gou Q, Xiong X, Cao D, He Y, Li X. Volar locking plate versus external fixation for unstable distal radius fractures: a systematic review and meta-analysis based on randomized controlled trials. BMC Musculoskelet Disord. 2021;22:433. Crossref
  • Van Oijen GW, Van Lieshout EMM, Reijnders MRL, et al. Treatment options in extra-articular distal radius fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2022;48(10):4333-4348. Crossref
  • Cui Z, Pan J, Yu B, Zhang K, Xiong X. Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis. Int Orthop. 2011;35(9):1333-1341. Crossref
  • Hassan SMT, Meeran G, Raza T, Akmal U, Ullah Z, Kakar AUK, et al. Evaluating Clinical and Radiological Outcomes of Ilizarov Ligamentotaxis and Volar Locked Plating in AO Type C2 and C3 Distal Radius Fractures: A Two-Year Prospective Observational Study. Cureus. 2025;17(9):e91663. Crossref
  • İsmailoğlu P, Nalbantoğlu U, Tok O, Bayramoğlu A, İsmailoğlu AV, Yıldırım FG. Distal radius morphometry of volar curvature along with scaphoid and lunate facet inclinations and ulnar variance in the Anatolian population. Sci Rep. 2026;16(1):35123. Crossref
  • Jensen J, Tromborg HB, Rasmussen SBSB, Gerke O, Torfing T, Precht H, et al. Dorsal Tilt of the Distal Radius Fracture Changes With Forearm Rotation When Measured on Radiographs. J Hand Surg Glob Online. 2021;3(4):182-189. Crossref
  • Mittal S, Agrawal AC, Sakale H, Kar BK. Distal radial fractures: Conservative treatment. J Orthop Dis Traumatol. 2020;3(2):41-44. Crossref
  • Ingall EM, Harper CM, Bernstein DN, Shoji MM, Merchan N, Rozental TD. Using the QuickDASH to Model Clinical Recovery Trajectory After Operative Management of Distal Radius Fracture. J Hand Surg Glob Online. 2021;3(1):1-6. Crossref
  • Ludvigsen T, Matre K, Gudmundsdottir RS, Krukhaug Y, Dybvik EH, Fevang JM. Surgical Treatment of Distal Radial Fractures with External Fixation Versus Volar Locking Plate: A Multicenter Randomized Controlled Trial. J Bone Joint Surg Am. 2021;103(5):405-414. Crossref
  • Maccagnano G, Noia G, Vicenti G, et al. Volar locking plate versus external fixation in distal radius fractures: A meta-analysis. Orthop Rev (Pavia). 2022;14(3):37050. Crossref
  • Norton B, Bugden B, Liu KPY. Functional outcome measures for distal radius fractures: A systematic review. Hong Kong J Occup Ther. 2022;35(2):115-124. Crossref
  • Salama AM, El-Adawy AM, Mashhour A, Bentaher MR. Results of ligamentotaxis technique in treatment of intra-articular distal radius fracture. Zagazig Univ Med J. 2022;28(6):152-157. Crossref
  • İpek E, Balkanlı B, Altuntaş Y, Cam N. Comparison of plate applications for distal radius fractures in semi-prone and supination. Hand Microsurg. 2025;14(1):33-40. Crossref
  • Lee CH, Kwon Y, Jung IY, Lee BG, Kim SJ. Effect of the Articular Surface Incongruency on Surgical Outcome of the Distal Radius Fracture. Biomed Res Int. 2022;2022:8357675. Crossref
  • Diepold J, Filipp S, Dussing F, Steiner G, Deininger C, Gotterbarm T, Wichlas F. Poor fracture alignment equals poor outcome? Analysis of conservatively managed distal radius fractures. Arch Orthop Trauma Surg. 2025;145:442. Crossref
  • Cruciani A, Giuli C, Di Pietro G, Cianni L, Fulchignoni C, Del Vecchio P, Maccauro G, Vitiello R. Epidemiology and treatment of surgical infections after distal radius fractures: a systematic review. Arch Orthop Trauma Surg. 2025;145:483. Crossref
  • Arveladze S, Moriarty F, Jennison T. The influence of pin material and coatings on the incidence of pin site infection after external fixation. J Limb Lengthen Reconstr. 2022;8(Suppl 1):S16-S23. Crossref
  • Halvachizadeh S, Dreifuss M, Rauer T, Kaiser A, Ubmann D, Pape HC, Allemann F. Does the AO/OTA fracture classification dictate the anesthesia modality for the surgical management of unstable distal radius fractures? A retrospective cohort study in 127 patients managed by general vs. regional anesthesia. Patient Saf Surg. 2025;19:2. Crossref
  • Hjelle AM, Gjertsen JE, Apalset EM, Nilsen RM, Lober A, Tell GS, Mielnik P. No association between osteoporosis and AO classification of distal radius fractures: an observational study of 289 patients. BMC Musculoskelet Disord. 2020;21:811. Crossref

Distal Radius'un Eklem İçi Kırıklarının Tedavisinde External Fiksatörün Etkinliği

Yıl 2026, Cilt: 9 Sayı: 1, 120 - 125, 17.03.2026
https://izlik.org/JA37AY67ZR

Öz

Amaç: Distal radius kırıkları günlük pratikte sık karşılaşılan yaralanmalar arasında yer alır. Özellikle eklem yüzeyini ilgilendiren tiplerde tedavi yaklaşımı hâlâ tartışmalıdır. Bu çalışmada eklem içi distal radius kırıklarında kapalı redüksiyon ve eksternal fiksatör ile tedavinin klinik etkinliğini araştırmayı hedefledik.
Yöntem: Ocak 2021 – Aralık 2022 arasında kliniğimizde tedavi edilen 53 hasta geriye dönük olarak incelendi. Tüm olgulara kapalı redüksiyon sonrası uniplanar radyokarpal eksternal fiksatör uygulandı. Kırıklar AO/OTA sınıflamasına göre C1, C2 ve C3 olarak gruplandırıldı. Radyolojik değerlendirmede radial inklinasyon, volar tilt, radial yükseklik, ulnar varyans ve artiküler basamak ölçüldü. Fonksiyonel sonuçlar modifiye Gartland-Werley skorlaması, radyolojik sonuçlar ise Sarmiento kriterleri ile değerlendirildi. Ağrı VAS skalası, üst ekstremite fonksiyonu DASH skoru ile takip edildi. Hastalar ortalama 16 ay izlendi.
Bulgular: Hastaların yaş ortalaması 48,6 yıldı ve çoğunluğu kadındı. Ameliyat sonrası radyolojik parametrelerin tamamında anlamlı düzelme görüldü (p<0,001). Son kontrolde VAS skoru 7,2'den 1,5'e, DASH skoru 48,6'dan 12,2'ye geriledi. Kavrama gücü sağlam tarafın %93,8'ine ulaştı. Fonksiyonel açıdan hastaların %54,7'si iyi veya çok iyi sonuç aldı. Kırık karmaşıklığı arttıkça sonuçlar kötüleşti (p<0,05). Komplikasyon oranı %30,2 olarak belirlendi.
Sonuç: Eksternal fiksasyon, eklem içi distal radius kırıklarında kabul edilebilir radyolojik ve fonksiyonel sonuçlar sunan pratik bir tedavi seçeneğidir.

Kaynakça

  • Gouk C, Ng SK, Knight M, Bindra R, Thomas M. Long term outcomes of open reduction internal fixation versus external fixation of distal radius fractures: A meta-analysis. Orthop Rev (Pavia). 2019;11(3):7809. Crossref
  • Diaz-Garcia RJ, Oda T, Shauver MJ, Chung KC. A systematic review of outcomes and complications of treating unstable distal radius fractures in the elderly. J Hand Surg Am. 2011;36(5):824-835. Crossref
  • Zahed M, Elmesalmi M, El Menawy Z, et al. Volar Locking Plate Versus External Fixation for Distal Radius Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus. 2026;18(1):e100789. Crossref
  • Gou Q, Xiong X, Cao D, He Y, Li X. Volar locking plate versus external fixation for unstable distal radius fractures: a systematic review and meta-analysis based on randomized controlled trials. BMC Musculoskelet Disord. 2021;22:433. Crossref
  • Van Oijen GW, Van Lieshout EMM, Reijnders MRL, et al. Treatment options in extra-articular distal radius fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2022;48(10):4333-4348. Crossref
  • Cui Z, Pan J, Yu B, Zhang K, Xiong X. Internal versus external fixation for unstable distal radius fractures: an up-to-date meta-analysis. Int Orthop. 2011;35(9):1333-1341. Crossref
  • Hassan SMT, Meeran G, Raza T, Akmal U, Ullah Z, Kakar AUK, et al. Evaluating Clinical and Radiological Outcomes of Ilizarov Ligamentotaxis and Volar Locked Plating in AO Type C2 and C3 Distal Radius Fractures: A Two-Year Prospective Observational Study. Cureus. 2025;17(9):e91663. Crossref
  • İsmailoğlu P, Nalbantoğlu U, Tok O, Bayramoğlu A, İsmailoğlu AV, Yıldırım FG. Distal radius morphometry of volar curvature along with scaphoid and lunate facet inclinations and ulnar variance in the Anatolian population. Sci Rep. 2026;16(1):35123. Crossref
  • Jensen J, Tromborg HB, Rasmussen SBSB, Gerke O, Torfing T, Precht H, et al. Dorsal Tilt of the Distal Radius Fracture Changes With Forearm Rotation When Measured on Radiographs. J Hand Surg Glob Online. 2021;3(4):182-189. Crossref
  • Mittal S, Agrawal AC, Sakale H, Kar BK. Distal radial fractures: Conservative treatment. J Orthop Dis Traumatol. 2020;3(2):41-44. Crossref
  • Ingall EM, Harper CM, Bernstein DN, Shoji MM, Merchan N, Rozental TD. Using the QuickDASH to Model Clinical Recovery Trajectory After Operative Management of Distal Radius Fracture. J Hand Surg Glob Online. 2021;3(1):1-6. Crossref
  • Ludvigsen T, Matre K, Gudmundsdottir RS, Krukhaug Y, Dybvik EH, Fevang JM. Surgical Treatment of Distal Radial Fractures with External Fixation Versus Volar Locking Plate: A Multicenter Randomized Controlled Trial. J Bone Joint Surg Am. 2021;103(5):405-414. Crossref
  • Maccagnano G, Noia G, Vicenti G, et al. Volar locking plate versus external fixation in distal radius fractures: A meta-analysis. Orthop Rev (Pavia). 2022;14(3):37050. Crossref
  • Norton B, Bugden B, Liu KPY. Functional outcome measures for distal radius fractures: A systematic review. Hong Kong J Occup Ther. 2022;35(2):115-124. Crossref
  • Salama AM, El-Adawy AM, Mashhour A, Bentaher MR. Results of ligamentotaxis technique in treatment of intra-articular distal radius fracture. Zagazig Univ Med J. 2022;28(6):152-157. Crossref
  • İpek E, Balkanlı B, Altuntaş Y, Cam N. Comparison of plate applications for distal radius fractures in semi-prone and supination. Hand Microsurg. 2025;14(1):33-40. Crossref
  • Lee CH, Kwon Y, Jung IY, Lee BG, Kim SJ. Effect of the Articular Surface Incongruency on Surgical Outcome of the Distal Radius Fracture. Biomed Res Int. 2022;2022:8357675. Crossref
  • Diepold J, Filipp S, Dussing F, Steiner G, Deininger C, Gotterbarm T, Wichlas F. Poor fracture alignment equals poor outcome? Analysis of conservatively managed distal radius fractures. Arch Orthop Trauma Surg. 2025;145:442. Crossref
  • Cruciani A, Giuli C, Di Pietro G, Cianni L, Fulchignoni C, Del Vecchio P, Maccauro G, Vitiello R. Epidemiology and treatment of surgical infections after distal radius fractures: a systematic review. Arch Orthop Trauma Surg. 2025;145:483. Crossref
  • Arveladze S, Moriarty F, Jennison T. The influence of pin material and coatings on the incidence of pin site infection after external fixation. J Limb Lengthen Reconstr. 2022;8(Suppl 1):S16-S23. Crossref
  • Halvachizadeh S, Dreifuss M, Rauer T, Kaiser A, Ubmann D, Pape HC, Allemann F. Does the AO/OTA fracture classification dictate the anesthesia modality for the surgical management of unstable distal radius fractures? A retrospective cohort study in 127 patients managed by general vs. regional anesthesia. Patient Saf Surg. 2025;19:2. Crossref
  • Hjelle AM, Gjertsen JE, Apalset EM, Nilsen RM, Lober A, Tell GS, Mielnik P. No association between osteoporosis and AO classification of distal radius fractures: an observational study of 289 patients. BMC Musculoskelet Disord. 2020;21:811. Crossref
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi
Bölüm Araştırma Makalesi
Yazarlar

İdris Perktaş 0009-0005-4582-1560

Serdar Menekşe 0000-0002-4121-8917

Gönderilme Tarihi 15 Ocak 2026
Kabul Tarihi 4 Mart 2026
Yayımlanma Tarihi 17 Mart 2026
IZ https://izlik.org/JA37AY67ZR
Yayımlandığı Sayı Yıl 2026 Cilt: 9 Sayı: 1

Kaynak Göster

APA Perktaş, İ., & Menekşe, S. (2026). Efficacy of an External Fixator in Treating Intra-Articular Fractures of the Distal Radius. Journal of Cukurova Anesthesia and Surgical Sciences, 9(1), 120-125. https://izlik.org/JA37AY67ZR
https://dergipark.org.tr/tr/download/journal-file/11303