External Fixation with Supplementary Intramedullary Kirschner Wires in the Treatment of Unstable Distal Radial Fractures

Jafer Jawad Al-Musawi, Mohammed

	External Fixation with Supplementary Intramedullary Kirschner Wires in the Treatment of Unstable Distal Radial Fractures
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 26, Issue 1, 2013, Pages 85-92
Author
Mohammed Jafer Jawad Al-Musawi
Abstract
Abstract Background: External fixation is a popular method to reduce osseous deformity of the distal radius, but cannot 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. Objectives: To determine radiographic and functional outcomes in unstable distal radius fracture treated by close reduction and external fixation, with supplementary intramedullary Kirschner wires. Patients & methods: 26 distal radius fractures were treated with external fixation supplemented with intramedullary wires. The fractures were evaluated via good-quality posteroanterior and lateral radiographs. 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. Results: In our study ,we found that there is a great relationship between radiological restoration of the length of distal radius and functional outcome ,using the Dermerit point-rating system ,we found that 23 patients (89% ) had excellent or good result ,2 patients (8%) were classified as fair ,and 1 patients (3%) had poor results. Radial height, volar tilt of distal radius deformity and radial inclination improved significantly immediately after surgery, when external fixation was supplemented with intramedullary Kirschner wires. Clinical examination likewise found significantly better functional results regarding range of motions & grips strength. Conclusion: External fixation is a popular method to reduce osseous deformity of the distal radius, but cannot 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. Keywords: Unstable distal radius, external fixation, K-wires
Keywords
Unstable distal radius; external fixation; wires

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