OBJECTIVETo compare the differences between external fixator and volar T-shaped plate in the treatment of complicated fractures of the distal radius and ulna, and evaluate the appropriate operation method for the fractures.

METHODSFrom July 2005 to July 2007, forty-eight cases of complicated fractures of the distal radius and ulna were treated with operation. There were 21 males and 9 females in the internal fixator group, ranged from 22 to 52 years old (with an average of 38.4 +/- 1.5 years). There were 10 mals and 8 femals in the external fixator group,ranged from 25 to 56 years old (with an average of 40.5 +/- 2.3 years). The X-ray films were measured to acquire radial length, palmar tilt and radial inclination after operations. The functional evaluation were scored with a modified Gartland and Werley's (GW) scoring system at 6 and 12 months after operation.

RESULTSThe patients were followed up for 12 to 18 months with an average of 14.2 months. The radial length was (8.82 +/- 0.55) mm, palmar tilt (9.23 +/- 0.86) degrees, radial inclination (19.66 +/- 1.38) degrees in the internal fixator group, while those were (8.25 +/- 0.36) mm, (8.56 +/- 0.72) degrees, (18.82 +/- 1.42) degrees in the external fixator group. The film parameter of internal fixator group was better than the external fixator group, but with no statistical significance (P > 0.05). In the internal fixator group, 16 cases obtained excellent, 7 good, 5 fair, 2 poor, while in the external fixator group, 4 cases obtained excellent, 2 good, 8 fair, 4 poor in 6 months. The GW scores of internal fixator group were lower than that of the external fixator group (P < 0.05). At 12 months after surgery, in the internal fixator group, 17 cases obtained excellent, 7 good, 5 fair, 1 poor; while in the external fixator group, 5 cases obtained excellent, 9 good, 2 fair, 2 poor. The GW score was similar between the two groups (P > 0.05).

CONCLUSIONThe volar T-shaped plate fixation may offer effective stability,the short-term outcome is better than the external fixator group,and there are relatively fewer complications. But the treatment outcome of the two operation methods are similar for the long time follow up.