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

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.

Anahtar Kelimeler

• Distal Radius Fractures
• External Fixators
• Fracture Fixation

Distal Radius'un Eklem İçi Kırıklarının Tedavisinde External Fiksatörün Etkinliği

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.

Anahtar Kelimeler

• Distal Radius Kırıkları
• External Fiksatör
• Kırık Sabitlemesi

Kaynakça

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