Dynamic external fixator yields comparable results to static fixator for distal radial fracture treatment

Hove LM. J Bone Joint Surg Am. 2010;92(8):1687-1696.doi:10.2106/JBJS.H.01236.

Continuous dynamic external fixation is an effective alternative to static external fixation when treating distal radial fractures, according to results of this prospective, randomized, multicenter study.

Leiv M. Hove, MD, PhD, University of Bergen, Norway, and colleagues designed a dynamic external fixator to treat distal radial fractures. In their study, they compared the anatomical and functional results of their fixator with those of current static bridging external fixators in 70 patients with unstable distal radial fractures.

Patients were randomized to either the dynamic external fixation group or the closed reduction external fixation with a static bridging fixator group. Patients in the dynamic fixator group began using their wrists the day after surgery. The static fixator patients were kept immobile for a mean of 6 weeks. Hove and colleagues assessed the patients clinically and radiographically when the fixator was removed and at 3, 6 and 12 months.

At all follow-up points, dynamic fixation restored radial length significantly better than did static fixation. There were no significant differences between the two groups with regard to radial tilt or inclination, the researchers wrote. Patients in the dynamic fixator group regained wrist flexion, radial deviation and pronation-supination significantly faster. Dynamic fixator patients had significantly better wrist extension at all follow-up points compared with the static fixator patients. At the latest follow-up, there were no differences between the two groups for Disabilities of the Arm, Shoulder and Hand scores and visual analog pain scores. Patients in the dynamic fixator group had significantly more superficial pin-track infections compared with the patients in the static fixator groups.