Percutanious Pinning And External Fixation In The Treatment Of Unstable Intraarticular Distal Radius Fractures
Journal Title: National Journal of Medical and Dental Research - Year 2017, Vol 6, Issue 1
Abstract
Introduction:We retrospectively compared the outcomes of external fixation and percutaneous pinning in treating similar unstable distal radius fractures with a minimum 12 month follow-up. Methods: Both groups included 40 patients with an average follow-up of 12 months. The external fixation group comprised 20 patients and percutanious pinning comprised 20 patients. Average age at presentation was 34 years in the external fixation group and 30 years in the percutanious group. The male/female ratios were 12:8 among the external fixation group and 11:9 in percutanious group. The two groups were compared for clinical and functional outcomes measured by the disabilities of the arm, shoulder, and hand (DASH) score. Pain scores were similar. Radiographic measurements were also evaluated between groups. Results: Final ranges of motion and grip strengths were similar between the two groups. The mean DASH score of the percutanious pinning group was 9 compared to 20 for the external fixation group. Radiographically, volar tilt and radial length were significantly better in the patients treated with external fixation group. The percutanious pinning group required less therapy visits. Complications occurred in percutanious pinning group, two patients had pin tract infections and Significant radial shortening was observed in 2 cases, Loosening of one of the K-wires was observed in 3 cases at the time of removal of the pins, and 2 had prolonged finger stiffness in external fixation group. Conclusion: external fixation compares favorably to and pinning for amenable fracture patterns. Whereas grip and range-of-motion data were similar, DASH scores, frequency of rehabilitation, and some radiographic parameters were superior in patients treated with external fixation. Although augmented external fixation represents a popular first line treatment for unstable fractures of the distal radius this study suggests that for fractures with minimal articular displacement similar clinical results can be obtained with percutaneous pinning and casting.
Authors and Affiliations
Abhilekh Mishra, Sandeep Bhinde, Sameer gupta
Keywords
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