ANATOMICAL AND FUNCTIONAL OUTCOME OF COMMINUTED INTRA-ARTICULAR DISTAL RADIAL FRACTURES TREATED WITH VOLAR BUTTRESS PLATING AND ANTI-IMPACTION KIRSCHNER WIRE THROUGH THE RADIAL STYLOID
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 16
Abstract
BACKGROUND Comminuted Colles’ fracture is common after accident and fall from height. Residual deformity after treatment adversely affect wrist motion and hand function.(1) Collapse on metaphysis and radial styloid with secondary osteoarthritis of wrist is common with comminution and displacement.(2) An anti-impaction K-wire is passed through radial styloid to medial cortex to prevent collapse along with ORIF with buttress plate.(3) MATERIALS AND METHODS This cohort study was to evaluate the functional and anatomical outcome of ORIF with plate and K-wire of Type-C distal radial fracture of 30 patients with intra-articular comminution AO type C1, C2 and C3 fracture between the aged 30 and 50 years. Polytrauma patients are excluded. All patients underwent ORIF through volar approach with buttress plate and anti-impaction care through radial styloid. After 4 weeks, K-wire was removed, and mobilisation started. Repeat x-ray was taken at 6th, 9th and 12th month. Evaluation is done with demerit point system and Gartland and Werley’s with Sarmiento modification. RESULTS We have got 73.3% excellent and 20% good result. In 66.7%, dorsal tilt is restored to anatomical palmar tilt and radial shortening is restored in 70.3% patient. Radiological evaluation was restored in 76% patients at final follow-up. On subject evaluation, 73.3% had excellent result and 1 poor result due to early spontaneous removal of K-wire loosening. CONCLUSION We have obtained 93% anatomical and 93% functional results. Our observation suggested stabilising distal radius fracture with volar plate and anti-impaction K-wire through radial styloid. Itis an effective method to prevent collapse and maintaining reduction till union, even when the fracture is comminuted and helps to prevent secondary osteoarthritis of the wrist.
Authors and Affiliations
Kumaran Chettiar K, Mohammed Rafi, Lakshmi Rajamma
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