External fixation with or without supplementary intramedullary Kirschner wires in the treatment of distal radial fractures.
OBJECTIVE
To determine radiographic outcomes in the fracture of distal radius treated by close reduction and external fixation, with or without supplementary intramedullary Kirschner wires..


METHODS
At the Orthopedic Department of National Taiwan University Hospital, we carried out a retrospective study of distal radial fractures treated with close reduction and external fixation. A consecutive series of 20 fractures were treated (from March 1995 to June 1998) with external fixation only; later (from January 1999 to December 2001), 36 distal radius fractures were treated with external fixation supplemented with intramedullary wires. The fractures were evaluated via good-quality posteroanterior and lateral radiographs. In both groups, the radial height, radial inclination and volar tilting were measured on initial (preoperative) and immediate postoperative radiographs and on others taken immediately after the removal of external fixation. Overall results were based on objective radiographic and functional data as well as on subjective assessments with demerit-point scoring. Data were analyzed with a 2-tailed t test.


RESULTS
Radial height and radial inclination improved significantly immediately after surgery, but volar tilting of distal-radius deformity was little improved by treatment with external fixation alone. When external fixation was supplemented with intramedullary Kirschner wires, improvement in all 3 measurements was statistically significant. Clinical examination likewise found significantly better functional results in patients treated with the Kirschner wires.


CONCLUSIONS
External fixation is a popular method too reduce osseous deformity of the distal radius, but can not assure maintenance of the reduction. Supplementing external fixation with intramedullary Kirschner wires can improve retention of fracture reduction during healing, resulting in better functional results.
Lin
Charles
C
Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.
Sun
Jui-Sheng
JS
Hou
Sheng-Mou
SM
D001864:Bone Wires; D005592:Fracture Fixation / Q000295:instrumentation*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation; D017102:Fracture Healing; D006801:Humans; D011885:Radius Fractures / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors