title: K-wire fixation for redislocated Colles' fractures. Malunion in 8/21 cases.
abstract: One therapeutic alternative for redislocation of Colles' fractures is closed reduction and transstyloid Kirschner-wire fixation. We describe our results concerning 21 redislocations treated in this way. According to Older's classification, B fractures were type 3 and 13 fractures type 4. After a median follow-up period of 2 years, most patients had regained normal volar tilt, but significant loss of radial tilt and radial length was found in 11 patients. Malunion occurred in 8 wrists due to either fracture comminution or insufficient K-wire fixation. According to Gartland and Werley's point system, the end-results were poor in 2, fair in 11, good in 4, and excellent in 4 wrists. There was no statistically significant difference in secondary displacement and functional end-result between Older's type 3 and type 4 fractures. We conclude that K-wire fixation is frequently not firm enough and external fixation might be a better alternative for stabilizing redislocated distal radial fractures.
authors.affiliation: Department of Surgery, Academic Hospital, University of Groningen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Oskam
authors.forename: J
authors.initials: J
authors.lastname: Kingma
authors.forename: J
authors.initials: J
authors.lastname: Bart
authors.forename: H J
authors.initials: HJ
authors.lastname: Klasen
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails; D001864:Bone Wires; D002370:Casts, Surgical; D003100:Colles' Fracture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology