External Fixation for Upper Extremity Trauma

Distal radius fractures are the most common fractures, accounting for 17% of fractures in the elderly population. Its treatment is challenging because of accompanying osteoporosis in this population. After the advantages of locking plates in osteoporotic bone stabilization were recognized, they became widely used as the treatment of choice in distal fractures of the radius. In low-energy fractures with no comminution, volar locking plate osteosynthesis is the current gold standard because it enables stable osteosynthesis and early joint mobilization. However, in high-energy fractures with many fragments, it is almost impossible to provide anatomic repositioning using open approaches. In such cases, fixation without opening the fracture and repositioning of fracture fragments by ligamentotaxis make the external fixator a feasible option. In this chapter, techniques and functional outcomes of external fixators in fragmented intra-articular radius distal fractures will be discussed in view of the current literature.