Thirty adults who had a severely comminuted intra-articular closed
fracture of the distal part of the radius were treated by closed reduction
and AO external fixation consisting of a converging-pin configuration with
a double row of connecting bars. The patients were followed for an average
of 2.6 years (range, two to four years). Twenty-seven patients had an
excellent result; two, a good result; and one, a poor result, on the basis
of pain, motion, strength, and radiographic appearance. Complications were
rare, and there was no loss of fixation of the pins. The average grip
strength was 92 per cent of normal. Motion of the wrist and rotation of the
forearm averaged more than 90 per cent of that of the normal side. Carpal
height was used as an indicator of distraction force produced by the
fixator. There was an average increase in carpal height of four millimeters
initially and 3.7 millimeters immediately before removal of the fixator,
indicating near-constant distraction throughout the treatment. Radial
length was well maintained, with shortening averaging less than one
millimeter. The converging pins of the AO fixator prevent loosening,
thereby diminishing the risks of infection, loss of reduction of the
fracture, and breakage of the pins. This geometry of the pins allows the
use of smaller-diameter (2.5-millimeter) pins and provides rigid fixation,
even in osteoporotic bone.