A Study on Functional Outcome of Joshi’s External Stabilization System in Distal Radius Comminuted Fractures

Background: Distal radius fractures are among the most common injuries treated by orthopedic surgeons in emergency settings, accounting for approximately 20% of all fractures. These fractures have a bimodal age distribution, predominantly affecting children/adolescents and the elderly. The objective is to evaluate the functional outcomes and complications of distal radius comminuted fractures treated with closed reduction and Joshi’s External Stabilization System (JESS). Material and Methods: The present prospective observational study was conducted in the Department of Orthopaedics, Bombay Hospital, Indore (M.P.). The study was undertaken for a period of 18 months from 2022 to 2024. Results: Of 101 patients (61.4% male, mean age 41.38 ± 13.98 years), 46.5% were aged 41–60 years. Road traffic accidents caused 69.3% of fractures, predominantly right-sided (58.4%). DASH scores improved significantly from 18.92 ± 6.44 at 6 weeks to 15.17 ± 5.89 at 6 months (p<0.001). Radiographic outcomes showed mean radial length of 10.31 ±1.26 mm, palmar tilt of 7.62 ± 4.73 degrees, and articular step-off of 0.69 ± 0.58 mm. Complications occurred in 19.8%, with stiffness (15.8%) most common; 80.2% had none. Range of motion neared normal (e.g., palmar flexion 62.87 ± 5.53 degrees). Conclusion: JESS effectively manages comminuted distal radius fractures, achieving satisfactory radiographic alignment, robust functional recovery, and a favorable complication profile. Its advantages—cost-effectiveness, ease of application, and minimal instrumentation—make it particularly valuable in resource-limited settings, where advanced implants are less accessible.

Keywords: Joshi’s External Stabilization System, Distal Radius, Comminuted Fractures.