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Plaster cast versus Clyburn external fixation for fractures of the distal radius in patients under 45 years of age.

In this prospective study, 70 patients between the ages of 20 and 45 years with comminuted intra-articular fractures of the distal radius of types III to VIII (graded according to Frykman) were treated either by closed reduction and forearm plaster (35 patients) or by application of a Clyburn dynamic external fixator (35 patients). The external fixator was more effective at holding the manipulated position, and the roentgenographic loss of position during fracture union was minimal compared with that seen in patients treated in plaster. Functional results in the fixator group were 18 excellent, 10 good, 6 fair, and 1 poor. The plaster group showed the following functional results: 12 excellent, 8 good, 10 fair, and 5 poor. The external fixator generated significantly better anatomical and functional results than did treatment with forearm plaster. A good anatomic position combined with early rehabilitation of the wrist function produced very favorable functional results in patients less than 45 years of age.