Functional and Radiological Outcome of Unstable Distal End Radius Fracture Treated with JESS

Objective: To evaluate the functional and radiological outcomes and complications of treating unstable, comminuted intra-articular fractures of the distal end of the radius (DER) using Joshi's External Stabilization System (JESS).

Methods: A prospective study was conducted on 30 patients with unstable intra-articular DER fractures, treated with JESS fixation between January 2023 and July 2024. Fractures were classified using Frykman's classification. Radiological outcomes were assessed using Sarmiento's modification of Lind Strom criteria, measuring radial inclination, radial length, and dorsal angulation. Functional outcomes were evaluated using the Patient Rated Wrist Evaluation (PRWE) score at 12 weeks and 6 months. Range of motion (ROM) measurements and complications were also recorded.

Results: The study cohort had a mean age of 35.96 ± 11.36 years, with a male predominance (80%). Road traffic accidents were the most common mechanism of injury (70%). The most common fracture types were Frykman type VIII (40%) and type VII (26.67%). At the 6-month follow-up, significant improvement was observed in all radiological parameters and ROM (p<0.0001 for all movements). According to the PRWE score, outcomes at 6 months were excellent in 33.33%, good in 36.66%, fair in 26.66%, and poor in 3.33% of patients. Complications included pin tract infection (6.66%), finger and wrist stiffness (6.66%), and malunion (3.33%).

Conclusion: JESS fixation is an effective treatment for unstable intra-articular fractures of the distal end of the radius, providing good to excellent functional and radiological outcomes with a low rate of complications. It is a viable, cost-effective option for managing these complex injuries.