A study to check use of additional transulnar k-wire in percutaneous cross k-wire pinning fixation of distal end radius fractures
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 8
Abstract
Introduction: Distal radius fractures are the most common type of orthopedic fracture. Some surgeons advocate treatment by manipulation and plaster immobilization. Many recommend operative intervention as the only methods to obtain anatomical reduction. In most displaced fractures of the radius, loss of reduction is likely to occur unless accurate management is provided. Inadequate fixation might result in gradual shortening at the fracture site during the healing process, even with excellent reduction. This article describes a technique that combines percutaneous cross Kirschner wire pinning fixation with additional transulnar k-wire for better stabilization of fracture fragments. Materials and Methods: This study includes 60 patients who were treated with percutaneous k-wire fixation for distal end radius fracture. They were divided in two groups. First group include 30 patients with cross pinning percutaneous k-wires while other group include 30 patients with additional transulnar k-wire in cross pinning k-wire fixation. The radial height, palmar tilt, radial inclination were measured pre-operatively and post-operatively in plain radiographs. Intraarticular fractures, pediatric fractures, associated other forearm fractures were excluded in study. Above elbow cast is applied immediate post op till 3 weeks, followed by below elbow cast for 3 weeks. K-wires and cast were removed after 6 weeks. The patients were followed up at 3, 6, 10, 14 weeks period .Clinical, radiological and functional reviews were performed at periodic intervals. Results: There was a significant difference from pre and post-operative values of radial height, palmar tilt, radial inclination in the cross pinning with additional transulnar patient group as compare to only cross pinning group. Additional transulnar k- wire was better at maintaining palmar tilt and radial height. Conclusion: Percutaneous fixation by additional transulnar k- wire fixation technique is an effective method to maintain the reduction, prevent radial collapse during healing, and to maintain the stability of the distal radioulnar joint even when the fracture is grossly comminuted or unstable.
Authors and Affiliations
Nitin Patil, Rupesh Gor, Ketan Gupta, Jimit Shah, Yash Jain
Keywords
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