Abstract
External fixation for severe fractures of the distal radius is accepted treatment offering the
potential advantages of controlled distraction, accurate positioning of fracture fragments, and
avoidance of extensive open procedures. One of the limitation of external fixation for distal
radius fractures is excessive distraction, which affect the outcome. This study was conducted to
evaluate the changes of the distraction of the intercarpal and radiocarpal joint, developed after
treatment of distal radius fractures with external fixator. Restrospective study was done for 28
paitents, who were evaluated by chart review, questionnaire, radiograph, and physical
examination. The carpal height ratio, radial inclination, velar tilt, radial length were measured in
the postoperative and follow-up radiographs. The carpal height ratio was used to quantify the
distraction. Functional evaluation was performed with Demerit-Point system described by
Garthland and Werley. Five fractures had an excellent results, 16 had a good results, 4 had a fair
results, and 3 had poor results. After union, average radial inclination was 21.3 degree, average
dorsal angulation was -0.5 degree, and radial shortening was 1mm. Increased carpal height ratio
of the 9 cases did not decrease to less than 0.56 at one year after operation. The over-distraction
of intercarpal and radiocarpal joint developed after external fixation of the distal radius fracture,
did not have decreased in the one year follow-up radiographs after operation. The over-
distraction should be avoided intraoperativly.