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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 6, 837-840.
doi: 10.1302/0301-620X.87B6.15608  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Unstable extra-articular fractures of the distal radius

A PROSPECTIVE, RANDOMISED STUDY OF IMMOBILISATION IN A CAST VERSUS SUPPLEMENTARY PERCUTANEOUS PINNING

T. Azzopardi, FRCSEd(Tr & Orth), Orthopaedic Registrar; S. Ehrendorfer, MD, Orthopaedic Consultant Surgeon; T. Coulton, MCSP, Orthopaedic Specialist Physiotherapist; and M. Abela, MD, MSc, FRCS(G)(Tr & Orth), Orthopaedic Surgeon

Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, UK, Wishaw General Hospital, Netherton Street, Wishaw, ML2 0DP, UK, St Luke’s Hospital, Guardamangia Hill, Guardamangia, MSD09, Malta.

Correspondence should be sent to Mr T. Azzopardi; e-mail: thomasazzopardi{at}hotmail.com

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°), 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.




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Distal radial fractures
Kalpesh Shah
J Bone Joint Surg Br Online, 23 Jun 2005 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General