External fixation of unstable wrist fractures

: The results of external fixation of 66 unstable distal radial fractures were evaluated. In the majority, the radiological results were excellent or good. There was a clear correlation between an excellent or good clinical score and the subsequent radiological result. Upper limb dystrophy which caused a considerable morbidity was found in every third patient. Unstable distal radial fractures with severe initial displacement predispose to reflex dystrophy. External fixation obviously cannot prevent this severe complication, it is even possible that tension on soft tissues, capsules and ligaments caused by ligamentotaxis might induce reflex dystrophy. Therefore, the indication for using external fixation of unstable distal radial fractures has to be defined with due caution.