Background: To study the functional outcome of AO type C3 distal radius fracture using external fixation and modified radial flexor carpi approach with contoured phalangeal plate as “hook plate” to treat small comminuted and unstable fracture fragments.
Method: Between June 2016 and October 2017, seven patients presenting with AO type C3 distal radius fracture were treated using modified radial flexor approach and external fixation. Radiographic assessment were based on preoperative and postoperative X-ray and CT imaging during follow-up visits. The grip strength, range of active motion and pain were recorded. Mayo writs score and Gartland and Werley score were obtained to evaluated functional outcome.
Results: The mean follow-up was 2 years. All patients achieved articular congruity and bone healing. The average Gartland and Werley score was 2.86 which indicated excellent outcome with minimal impairment to daily life. The average Mayo score was 87.5 which overall was a good score, 3 patients (42.9%) had excellent score and 4 patients (57.1%) had good score. No complications such as radioulnar instability and implant failure occurred.
Conclusion: Our results suggest rapid functional outcome and range of motion at the wrist with minimal complications. This technique is effective and addresses the challenges in treating unstable AO type C3 distal radius fracture. Installing the external fixator first provides adequate reduction and enhances stability while the bent phalangeal plate serves as a buttress to grab and fix small fracture fragments.