Functional evaluation of surgical fixation of distal radius


  • Ramdas Maloth Department of Orthopedics, Dhanalaxmi Srinivasan Medical College, Perambur, Tamil Nadu, India



Surgical fixator, Gartland and wereley scoring system, Closed reduction, Trauma, Distal radius fracture, Comminuted fracture


Background: Distal radius fractures are the most recurrent fractures happening in the upper extremity. We conducted a prospective hospital-based clinical study on the management of distal radius fractures with surgical fixation. To assess functional outcome and to assess the effectiveness of surgical fixation in the intra-articular distal end of radius fractures.

Methods: This prospective study comprised 40 patients treated with surgical fixation. The patients were followed up at six weeks, three months, 6 months and one year after surgery. The assessment of pain, range of motion, grip strength and activity were assessed and scored according to Gartland and Werley scoring systems. Radiographic measurements were also evaluated.

Results: Gartland and Wereley scoring were used to evaluate the overall functional results. Excellent to good results were in 85% of patients, and fair to poor results were seen in 15% of patients. Two patients developed pin site infections.

Conclusions: Surgical fixation used for ligamentotaxis is an effective method of treating intra articular distal radius fractures.


Solvang HW, Nordheggen RA, Clementsen S, Hammer OL, Randsborg PH. Epidemiology of distal radius fracture in Akershus, Norway, in 2010-2011. J Orthop Surg Res. 2018;13(1):199.

Shauver MJ, Yin H, Benerjee M. Current and future national costs of Medicare for treatment of distal radius fractures in elderly. J Hand Surg. 2011;36:1282-7.

Sommerkamp TG, Seeman M, Silliman J. Dynamic external fixation of unstable fractures of the distal part of the radius. A prospective, randomized comparison with static external fixation. J Bone Joint Surg Am. 1994;76(8):1149-61.

Wong KK, Chan KW, Kwok TK, Mak KH. Volar fixation of dorsally displaced distal radius fractures using LCP. J ortho. 2015;13:153-7.

Weiland A. External fixation, not ORIF, as the treatment of choice for fractures of the distal radius. J Orthop Trauma. 2009;13:570-2.

Green DP. Pins and plaster treatment of communited fracture of the distal end of the radius. JBJS. 2015;57-A:304-10.

Trumble TE, Culp RW, Hanel DP, Geissler WB, Berger RA. Intra-articular fractures of the distal aspect of the radius. Instructional Course Lectures. 2019;48:465-80.

Auge W, Velazque P. The application of indirect reduction technique in the distal radius; the role of adjuvant arthroscopy. Arthroscopy. 2013;16:830-5.

Cole RJ, Bindra RR, Evanoff BA. Radiographic evaluation of osseous displacement following intra articular fracture of distal radius; reliability of plain radiographs versus computed tomography. J Hand Surgery. 2017;22:792-800.

Margaret M, James M, Heckman D. Rockwood and Green’s fractures in adults 8th edition, Vol. 1, 1081-1089.

Knirk JL, Jupiter JB. Intra-articular fracture of distal end of radius in young adults. J Bone Joint Surg. 2016;68:647-59.

Melone CP. Distal radius fractures: patterns of articular fragmentation. Orthop Clin North Am. 2013;24:239-53.

Mehta JA, Bain GI, Heptinstall RJ. Anatomical reduction of intra-articular fractures of the distal radius. J Bone Joint Surg Br. 2007;82-B:79-86.

Wright TW, Horodyski M, Smith DW. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg. 2015;30(2):289-99.

Rizzo M, Katt BA, Carothers JT. Comparison of locked volar plating versus pinning and external fixation in the treatment of unstable intraarticular distal radius fractures. HAND. 2018;3(2):111-7.

Lin C, Sun JS, Hou SM. External fixation with or without supplementary intramedullary Kirschner wires in the treatment of distal radial fractures. Canadian J Surg. 2014;47(6):631-7.






Original Research Articles