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External fixation of distal radius fractures may be used in a bridging or nonbridging manner. Bridging external fixation of distal radius fractures typically relies on ligamentotaxis to both obtain and maintain a reduction of the fracture fragments. As longitudinal traction is applied to the carpus, the tension is transmitted mostly through the radioscaphocapitate and long radiolunate ligaments to restore the radial length. In a similar vein, pronation of the carpus can indirectly correct the supination deformity of the distal fragment.

Limitations of Ligamentotaxis

Ligamentotaxis has a number of shortcomings when applied to the treatment of displaced intra-articular fractures of the distal radius. First, since ligaments exhibit viscoelastic behavior,[5] there is a gradual loss of the initial distraction force applied to the fracture site through stress relaxation.[6]The immediate improvement in radial height, inclination, and volar tilt are significantly decreased by the time …