Functional and Radiological Outcomes of Distal Radius Fractures Treated with Closed Reduction and Percutaneous Five Pin Technique – A Prospective Cohort Study
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2014, Vol 10, Issue 3
Abstract
Distal radius fractures are one of the most common fractures occurring in adults. Despite several advances, the ideal treatment is yet to be agreed upon. Traditional methods of reduction and plaster have been associated with stiffness of hand and latemetaphyseal collapse, while open reduction techniques have the risk of devascularisation and non-union. The search is still on for the ideal compromise. Closed pinning with 2or 3 pins has been tried before with limited success. In this study a new technique with five pins ,was used and the ulna was also engaged in the fixation .Materials and Methods: All consecutive cases of distal radius fractures, A.O. types A,B and C, presenting to the casualty or Outpatient department and aged between 20 to 70 years of age, without concomitant ulnar fracture were recruited. Anatomical and Radiological results were graded according to Sarmiento’s modification of Lindstrom’s criteria; the results were evaluated using Wilcoxon signed rank test for statistical significance. The functional results were graded according to Mayo’s Wrist score. Excellent and good results were taken together as acceptable. Results: The average follow up was 5 months ranging from 3 to 6 months..On evaluation of anatomical results 80% had excellent, 13.33% had good and 6.66% had fair results. No patients had poor results in our series. Comparison of pre and postoperative scores showed statistically significant improvement with P value< 0.05.Functionally 33.33% had excellent, 60 % had good and 6.66% had fair results. Lower grades on the function correlated with residual deformity and impaired grip strength. One patient had pin tract infection and one patient reflex sympathetic dystrophy .Conclusion: Fractures of the distal radius whether intra or extra articular when treated with percutaneous pinning have excellent to good results in 94%on the restoration of radiological anatomy and about94% on rating of the functional outcome .Loss of volar tilt, radial inclination and radial length has not been observed as in other series suggesting that this technique may be the answer to the questions of stability and the need for early mobilisation.
Authors and Affiliations
Cherian Jacob , Anoop R L , Nithin Thomas Philip
Keywords
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