title: Unstable extra-articular fractures of the distal radius: a prospective, randomised study of immobilisation in a cast versus supplementary percutaneous pinning.
abstract: We performed a prospective, randomised study on 57 patients older than 60 years of age with unstable, extra-articular fractures of the distal radius to compare the outcome of immobilisation in a cast alone with that using supplementary, percutaneous pinning. Patients treated by percutaneous wires had a statistically significant improvement in dorsal angulation (mean 7 degrees), radial length (mean 3 mm) and radial inclination (mean 3 mm) at one year. However, there was no significant difference in functional outcome in terms of pain, range of movement, grip strength, activities of daily living and the SF-36 score except for an improved range of movement in ulnar deviation in the percutaneous wire group. One patient developed a pin-track infection which required removal of the wires at two weeks. We conclude that percutaneous pinning of unstable, extra-articular fractures of the distal radius provides only a marginal improvement in the radiological parameters compared with immobilisation in a cast alone. This does not correlate with an improved functional outcome in a low-demand, elderly population.
authors.affiliation: Wishaw General Hospital, Netherton Street, Wishaw, Scotland. thomasazzopardi@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Azzopardi
authors.forename: S
authors.initials: S
authors.lastname: Ehrendorfer
authors.forename: T
authors.initials: T
authors.lastname: Coulton
authors.forename: M
authors.initials: M
authors.lastname: Abela
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires; D002370:Casts, Surgical; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000601:surgery*