External fixation for comminuted intra-articular wrist fractures

We treated 101 consecutive patients with Frykman type III, IV, VII and VIII fractures of the distal radius and ulna with the small Hoffman external fixator between 1986 and 1989. All patients were reviewed after a mean follow-up period of 22 months (range: 12 to 45 months). At follow-up, 88 wrists (87%) were rated good or excellent, according to the demerit point system, and 13 wrists (13%) were rated fair or poor according to the same system. A highly significant correlation (p less than 0.01) was found between the overall scores at follow-up and the grade of postoperative articular incongruity, between the overall scores and the grade of osteoarthritis at follow-up, between the grade of postoperative articular incongruity and the grade of osteoarthritis at the follow-up, as well as between the overall scores and the grip strength at follow-up. A significant correlation (p less than 0.05) was found between the length of follow-up and the grade of osteoarthritis at follow-up. Although the complication rate was rather high (40%), most of these problems were minor, transient and pin-related.