External fixation or plaster cast for severely displaced Colles' fractures? Prospective 1-year study of 46 patients.

In a prospective randomized study of 47 severely displaced Colles' fractures, 23 had external fixation and 24 had a dorsal plaster cast. Five fractures in the plaster-cast group redislocated and were externally fixed at rereduction after the 11-day follow-up. Three patients in the external-fixation group had a noncomplicated pin-tract infection, and 1 patient had a transient sensory disturbance arising from the cutaneous branch of the superficial radial nerve. After 1 year, the patients allocated to primary external fixation had a better radiographic and functional end result; according to Lidström's grading, 19/22 were excellent or good after external fixation as compared with 12/19 after plaster-cast treatment.