838 THE JOURNALOF BONE AND JOINT SURGERY LIGAMENTOTAXIS AND BONE GRAFTING FOR COMMINUTED FRACTURES OF THE DISTAL RADIUS

The conventional treatment of comminuted fractures in the distal radius has been unsatisfactory. We therefore made a prospective study using the principle ofligamentotaxis and primary cancellous bone grafting as the uniform method of treatment. Ligamentotaxis was maintained by using an external fixator for three weeks only, after which a carefully monitored programme of rehabilitation was given. We have reviewed 72 consecutive distal radial fractures after a follow-up of 7 to 40 months (average 11 months). Reduction had been maintained during healing and over 80 % of patients regained full range of movement in hands, wrists and forearms with strong and pain-free wrist function. Complications were infrequent and gave no real problems. We conclude that distraction, external fixation and bone grafting appears to be an excellent method of treating comminuted fractures of the distal radius. The conventional treatment of comminuted fractures of the distal radius has been disappointing. Closed reduction and plaster often allows early redisplacement with angulation or late collapse. Open reduction is possible but there is no effective means of internal fixation. The use of external fixators has shown promising results, but