Osteosynthesis and Trauma Care 2002; 10(3): 141-146
DOI: 10.1055/s-2002-37328
Original Article

© Georg Thieme Verlag Stuttgart · New York

External Fixators for Distal Radius Fractures

Therapy and Results Based on 25-Years Experience with External FixatorsG. Asche1
  • 1Regional Hospital Freudenstadt, Freudenstadt, Germany
Further Information

Publication History

Publication Date:
20 February 2003 (online)

Abstract

The procedure called “ligamentotaxis” or distraction of capsulo-ligamentous structures first described by Vidal was seen as an option for external fixator management of fractures involving the wrist joint. We have been propagating this technique in German- speaking countries since 1978 and have extended its indication to all types of fractures with the exception of flexion fractures in which plate osteosynthesis is indicated. The long-term results of a large-scale follow-up study with more than 300 patients are presented. Therapeutic and functional outcome was good overall. Strikingly, anterior displacement of the ulna form feed was being less than 5 mm in 90 % of the cases. This was found despite the fact that no cancellous bone grafting was performed in a patient population consisting of mostly over 70-year-olds and that most of the fractures were Frykman type VII and VIII. The radiological results based on the Lidström classification were good to very good in 91.3 %, with 97.8 % of the patients expressing great satisfaction with the outcome of their treatment. However, these results can only be achieved with frame assemblies that are both elastic but stable at the same time. Today, external fixators belong to the standard arsenal for treatment of radius fracture with typical locations and fulfill the therapeutic principles set forth by L. Böhler back in the year 1941.

References

  • 1 Asche G. Stabilisierung von handgelenksnahen Speichenbrüchen mit dem Midifixateur externe: 22. Symposium Deutschsprachige Arbeitsgemeinschaft für Handchirurgie 1981.  Handchirurgie. 1983;  15 38-42
  • 2 Asche G. Die Behandlung der distalen Radiusfraktur mit dem Midifixateur externe. In: Nigst H (Ed.) Frakturen der Hand und des Handgelenkes. Hippokrates, Stuttgart 1987; pp 37-41
  • 3 Asche G. Die dynamische Behandlung von handgelenksnahen und handgelenksbeteiligenden Speichenbrüchen mit einem neuartigen Bewegungsfixateur.  Aktuelle Traumatol. 1990;  1 6-10
  • 4 Asche G. Die Behandlung von Speichenbrüchen mit einem neu entwickelten dynamischen Bewegungsfixateur.  Zentralbl Chir. 1995;  120 952-958
  • 5 Asche G, Roth W, Schröder L. Fixateur externe Standard-Indikationen, Operationsanleitung und Montagebeispiele. Reinbeck: Einhorn-Presse Verlag
  • 6 Böhler L. Die Technik der Knochenbruchbehandlung im Kriege und im Frieden. 7th Edition, Maudrich, Vienna 1941
  • 7 Poigenfürst J. Brüche am distalen Unterarmende.  Unfallheilkunde. 1980;  148 53-59
  • 8 Vidal J, Buscayret C, Fischbach C, Brahin B, Paran M, Escare P. Une méthode original dans le traitement des fractures comminutives du radius: “Le taxis ligamentaire”.  Acta Orthop Belg. 1977;  43 781-789
  • 9 Kummer B. “The External Fixator”. In: Asche G, Roth W, Schröder L (eds). Fixateur externe. Reinbeck: Einhorn-Presse Verlag 2000; 66 - 86

Dr. Gernot Asche

Karl von Hahn Straße

72250 Freudenstadt

Germany

Phone: +49/74 41 /54 63 48

Email: gernot.asche@t-online.de

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