Management of Unstable Pediatric Distal Radius Fractures With a 2-Pin External Fixator and a Short Arm Cast: Technique and Case Series

Introduction: Pediatric distal radius fractures that are unacceptably aligned and undergo closed reduction are often redisplaced when immobilized in a cast alone without additional fixation. Percutaneous pinning, plate and screw fixation, and 4-pin wrist joint and physis-spanning external fixation constructs have previously been described to achieve and maintain reduction. Technique and Results: We successfully treated and followed 12 consecutive pediatric patients presenting with malaligned, nonphyseal distal radius fractures that were reduced and held with a 2-pin external fixation construct that did not extend distal to the physis, supplemented by a short arm cast. No complications were encountered in this series of patients. Conclusion: Two-pin external fixation is an alternative solution for completely displaced or markedly angulated pediatric distal radius fractures.