External fixation. Technical advances based upon multiplanar ligamentotaxis.

The principle of ligamentotaxis obtained by longitudinal traction is useful in restoring skeletal length to distal radial fractures. Using external skeletal fixation to translate the hand in radial-ulnar and dorsal-palmar directions, ligamentotaxis in two additional planes aligns and tilts the distal radial fragment and its articular surface. Following restoration of palmar tilt by palmar translation, wrist position can be adjusted into neutral or extension to help avoid finger stiffness and carpal tunnel syndrome without compromising fracture reduction.