Management of Distal End Radius Fractures in Adults By Ligamentotaxis Using An External Fixator With Radial Distractor: A Prospective Study

Abstract

Background: Distal radius fractures are among the most common fractures encountered in orthopaedic practice, accounting for approximately one-sixth of all fractures presenting to emergency departments. Unstable and intra-articular fractures often result in loss of anatomical alignment, decreased wrist function, and post-traumatic arthritis if not managed appropriately. External fixation based on the principle of ligamentotaxis has emerged as an effective treatment modality for maintaining fracture reduction while minimizing additional soft tissue injury. This study was undertaken to evaluate the functional and radiological outcomes of distal end radius fractures managed using an external fixator with a radial distractor.

Methods: A prospective observational study was conducted on 40 adult patients with distal end radius fractures treated by ligamentotaxis using a UMEX external fixator with radial distractor. Patients fulfilling the inclusion criteria underwent surgical fixation followed by a standardized postoperative rehabilitation protocol. The mean age of the study population was 44.8 years. The external fixator was maintained for an average duration of 6.5 weeks, and patients were followed for a mean period of 9 months. Functional outcomes were assessed using the Modified Green and O'Brien Clinical Scoring System, while fracture union, anatomical restoration, and complications were evaluated clinically and radiographically.

Results: The majority of patients achieved satisfactory anatomical reduction and fracture union following treatment with external fixation. Functional assessment at the final follow-up demonstrated excellent to good outcomes in 90% of patients according to the Modified Green and O'Brien scoring system. The procedure provided stable fixation, restoration of radial length and alignment, and facilitated early rehabilitation. Complications were minimal and were managed successfully without significantly affecting the final functional outcome.

Conclusion: External fixation with radial distractor based on the principle of ligamentotaxis is a reliable and effective treatment option for unstable distal end radius fractures. It provides satisfactory anatomical restoration, stable fracture fixation, and excellent functional outcomes with a low complication rate. Successful treatment depends on careful patient selection, meticulous surgical technique, maintenance of reduction, and early supervised rehabilitation.