Comparison between Distractor Application on Both Radial & Ulnar Side and Radial Side Only for Fracture Distal Radius with Ulnar Styloid Fracture


Background: Fracture of distal radius with involvement of the ulnar styloid process is a common clinical problem. It can be treated conservatively, usually involving wrist immobilization in plaster cast or surgically. A key method of surgical fixation is external fixation by distractor. Distractor can be applied either only on the radial side or on both ulnar and radial sides. Materials and Methods: A prospective randomized and comparative study of 1 year duration was conducted on 32 patients admitted in the Department of Orthopaedics of BSMC & H in the age group of 20 to 75 years old with AO types B and C distal radius fracture along with involvement of the ulnar styloid process. The parameters studied were restoration of radial length, restoration of radial angle, intracarpal step-off and palmar tilt which were statistically evaluated and Fisher’s exact test was performed. The two tailed P-value was calculated and both the groups were statistically compared. Results: In our study, 37.5% patients in Group A and 81.25% in Group B had a radial difference <3 mm which was statistically significant (Table 1, Chart 1). 43.75% patients in Group A and 87.5% in Group B had radial angle <5’ which was significant (Table 2, Chart 2). 31.25% in Group A and 75% had intra carpal step off <2 mm which was again statistically significant (Table 3, Chart 3). 62.5% had an abnormal palmar tilt in Group A while only 6.25% had an abnormal palmar tilt in Group B which is extremely statistically significant. On an average, 2 mm of distraction was required in 75% patients of Group A while only 30% patients in Group B required distraction (Table 4, Chart 4). Conclusion: In our study, the radial difference, radial angle, intra carpal step off and palmar tilt returned significantly to normal in the patients treated with distractor on radial side only when compared with distractor application on both radial and ulnar sides for distal radius fracture with ulnar styloid process involvement. Also post-operative distraction required under image intensifier was higher in the group treated with distractor on either side than those with distractor only on radial side.

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U. Bhakat, A. Mukherjee and R. Bandyopadhyay, "Comparison between Distractor Application on Both Radial & Ulnar Side and Radial Side Only for Fracture Distal Radius with Ulnar Styloid Fracture," Open Journal of Orthopedics, Vol. 3 No. 5, 2013, pp. 227-233. doi: 10.4236/ojo.2013.35043.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. T. Capo, W. Rossy, P. Henry, R. J. Maurer, S. Naidu and L. Chen, “External Fixation of Distal Radius Fractures: Effect of Distraction and Duration,” Journal of Hand Surgery (American Volume), Vol. 34, No. 9, 2009, pp. 1605-1611.
[2] “Campbell’s: Fracture of Distal Radius: Fracture & Dislocation,” 11th Edition, Mosby Elsevier, 2008, pp. 3441-3452.
[3] J. Vasenius, “Operative Treatment of Distal Radius Fractures,” Scandinavian Journal of Surgery, Vol. 97, No. 4, 2008, pp. 290-297.
[4] H. J. Kreder, D. P. Hanel, J. Agel, M. McKee, E. H. Schemitsch, T. E. Trumble and D. Stephen, “Indirect Reduction and Percutaneous Fixation versus Open Reduction and Internal Fixation for Displaced Intra-Articular Fractures of the Distal Radius: A Randomised, Controlled Trial,” Journal of Bone and Joint Surgery (British Volume), Vol. 87, No. 6, 2005, pp. 829-836.
[5] D. S. Ruch, J. Vallee, G. G. Poehling, et al., “Arthroscopic Reduction versus Fluoroscopic Reduction in the Management of Intra-Articular Distal Radius Fractures,” Arthroscopy, Vol. 20, No. 3, 2004, pp. 225-230.
[6] T. Gausepohl, D. Pennig and K. Mader, “Principles of External Fixation and Supplementary Techniques Distal Radius Fractures,” Injury, Vol. 31, Suppl. 1, 2000, pp. 56-70. doi:10.1016/S0020-1383(99)00264-8
[7] W. Dee, W. Klein and H. Rieger, “Reduction Techniques in Distal Radius Fractures,” Injury, Vol. 31, Suppl. 1, 2000, pp. 48-55. doi:10.1016/S0020-1383(99)00263-6
[8] J. Bruske, Z. Niedzwiedz, M. Bednarski, et al., “Acute Carpal Tunnel Syndrome after Distal Radius Fractures Long Term Results of Surgical Treatment with Decompression and External Fixator Application,” Chir Narzadow Ruchu Ortop Pol, Vol. 67, No. 1, 2002, pp. 47-53.
[9] D. T. Hutchinson, K. N. Bachus and T. Higgenbotham, “External Fixation of the Distal Radius: To Predrill or Not to Predrill,” Journal of Hand Surgery (American Volume), Vol. 25, No. 6, 2000, pp. 1064-1068. doi:10.1053/jhsu.2000.17866
[10] H. J. Kreder, D. P. Hanel, J. Agel, et al., “A Randomized Controlled Trial of Closed Reduction and Casting versus Closed Reduction and External Fixation for Distal Radius Fractures with Metaphyseal Displacement but without Joint Incongruity,” Orthopaedic Trauma Association 18th Annual Meeting, 13 October 2002.

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