[Open pulling reduction and bone graft by overstretched wrist traction and internal fixation for the treatment of distal radius type Fernandez Ⅲ fractures].

OBJECTIVE

To explore the clinical effect of the treatment of Fernandez type Ⅲ fracture of the distal radius with hyperextension traction prying, volar reduction, bone grafting and internal fixation.

METHODS

From February 2017 to March 2018, 11 cases of Fernandez type Ⅲ fracture of the distal radius were treated with intraoperative hyperextension traction and volar prying reduction and bone grafting and internal fixation, including 6 males and 5 females, aged 55 to 67 years. Preoperative X-ray and CT evaluated the distal radius fracture dorsal angulation with articular surface compression, collapse. According to Fernandez, all of them were type Ⅲ. After operation, the reduction of articular surface and fracture healing were evaluated. VAS score and Cooney wrist score were used to evaluate the curative effect.

RESULTS

All the patients were followed up for 12 to 14 months. All the fractures healed. Cooney wrist score scale was used to evaluate the curative effect, 9 cases were excellent, 1 case was good and 1 case was fair.

CONCLUSION

In the operation of Fernandez type Ⅲ fracture of the distal radius, hyperextension traction was used to enlarge the angle, and through the volar fracture end prying reduction and internal fixation with bone graft, the collapsed articular surface could be effectively reduced and fixed. The early functional exercise after the operation had satisfactory clinical effect.