International Journal of Research in Orthopaedics | September-October 2017 | Vol 3 | Issue 5 Page 1004 International Journal of Research in Orthopaedics Dash SK et al. Int J Res Orthop. 2017 Sep;3(5):1004-1009 http://www.ijoro.org Original Research Article Clinical outcomes in management of unstable distal radius fractures treated with external fixation and internal fixation: a prospective comparative study Sunil Kumar Dash 1 *, Manish Kumar Sharma 1 , Sanket Mishra 1 , Hatia Marandi 1 , Aurobinda Das 1 , Deepankar Satapathy 2 , Syed S. Ahmed 1 INTRODUCTION Orthopaedics literature widely accepts that the restoration of the distal radius anatomy is strongly linked to functional restoration. 1 Any treatment modalities should be primarily aimed at restoring radial articular congruity, alignment, length, motion and stability. This mostly implies that operative intervention becomes essential for management unstable DRFs to achieve successful outcomes. 2 However, exact management of patients with unstable DRFs remains controversial. There is no definitive evidence to support one surgical fixation method scores over another. Currently, operative management of unstable DRFs mainly includes external fixation (EF) and internal ABSTRACT Background: Management of Distal Radius fracture that are inherently unstable is still a matter of debate. There is no conclusive evidence that support one surgical fixation method over another. An attempt was made to analyze patients treated with Ex-Fix and Internal-Fixation for unstable distal radius fractures and evaluate the clinical efficacy of Ex-fix using principles of ligamentotaxis and Internal-fixation and compare functional recovery, fracture healing time and complications. Methods: A prospective trial was undertaken at our hospital with 35 patients,all aged >20 yrs with closed distal radius fracture and divided into two groups: group I (Ex-fix with or without percutaneous k-wire, and JESS) and group II (Int-Fixation) including 14 and 21 patients, respectively. Periodic clinical examination and x-ray review was carried out to find out fracture union, and functional assessment. Patients were followed up for 1 year, 6 months average. Results: Group I consumed significant less operative time, fluoroscopic exposure, reduced hospital stay, quicker post-operative pain relief. Quick DASH score were significantly high in elderly treated with Ex-Fix in comparison to young in which DASH score was higher with internal-fixator. Functional recovery was early with int-fixation but post-operative wrist stiffness was also higher. 2 cases of delayed wound healing &1 case of pin tract infection with ex-fix application was observed. Conclusions: Internal-fixation remains the treatment of choice for unstable distal radius fracture involving the articular surface and in the young, while ext-fixation can be considered as a primary treatment modality in the extra- articular fractures in young or even intra-articular fractures in the elderly. Keywords: Distal radius, Ex-fix, Ligamentotaxis, DASH score 1 Hi- Tech Medical Hospital, 2 IMS and SUM Hospital, Bhubaneswar, Odisha, India Received: 29 April 2017 Revised: 04 July 2017 Accepted: 08 July 2017 *Correspondence: Dr. Sunil Kumar Dash, E-mail: manish8646@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20173932