[Continuous skeletal traction in multifragmentary fractures of radius and ulna combined with cast].

Introduction: Fractures of the distal third of the radius are frequently encountered in emergency services. Until recently considered as benign, however, they represent a group of numerous therapeutic problems, as debated in anatomical, radiological and clinical studies.
Objective: To emphasize the importance of recovering the radial distance and the articular congruence in fractures of radius treated with a cast.
Hypothesis: To demonstrate that ligamentotaxis obtained with the application of the Cole-Obletz technique is a good method for treatment of distal radius fractures that have a component of impaction, extra or intra-articular lesion, a combination of both.
Material and Methods: A retrospective study was realized on 10 patients with fractures of the distal radius, between February 2005 and February 2006, including adult patients of both genders. All patients received the Cole-Obletz method and were evaluated by antero-posterior and lateral wrist simple X-rays. According to Frykman classification, we compaired results in the immediate post-reduction X-rays with the results obtained at one month of treatment. Three different radiographic measures were evaluated: radius distance, inclination and volar tilt of the radius.
Results: We evaluated a group of 10 patients (80% female), with mean age of 52 years-old (24-79). Thirty percent of the patients (30%) presented a type VIII fracture, fourty percent a type VII fracture, and one patient for types V, IV, and II fractures, respectively. Articular congruence was achieved in the 80% of patients until full consolidation, in 10% of the patients only a 50% of radius distance was completed. In a patient anatomic reduction was lost on day eight.
Discussion: Treatment of complex distal radius fractures with plates and screws for maintaining anatomic reduction are not applicable in our socioeconomic context. This study was aimed to prove that the Cole-Obletz method permits to maintain adequate reduction, it is reproducible, and is achievable at low costs.