Complex articular fractures of the distal radius: The role of closed reduction and external fixation

Twenty-two patients underwent surgery for 23 complex articular fractures of the distal radius of C.3 type, according to the AO classification. The surgical treatment consisted, in all cases, of a closed, or limited-open, reduction and external fixation. The functional and radiographic results were analysed at a mean follow-up of 40 months. This retrospective study confirms that satisfactory functional results where obtained in 12 out of the 15 wrists where all the intra and extraarticular parameters of the Fernandez' criteria where respected. For those wrists where keeping with Fernandez' criteria for intraarticular parameters and ulnar variance was not possible, four of eight had satisfactory results. As far as the acceptability criteria for radial inclination and dorsal tilt are concerned, the functional results seem to suggest that a little wider tolerance than proposed in the literature could be accepted.