A Novel Method of Closed Reduction and Percutaneous Pinning With Six K-wires for Intra-articular Fractures of the Distal Radius.

Abstract

The existing method of closed reduction cannot reduce the complete intra-articular fracture of the distal radius; none of the available methods of percutaneous pinning alone can fix the intra-articular fracture of the distal radius. A prospective study including 108 complete intra-articular fractures of AO type B and C in 108 patients was conducted from 2013 to 2018. The subjects were aged between 18 and 84 years and included 61 men and 47 women. The cohort was divided into three age groups: ages 18 to 44, ages 45 to 59, and ages 60 to 84. The surgical technique includes an innovative method of closed reduction of the fracture in four steps, namely, distraction, compression, milking of the comminuted fragments, and repositioning of distal radio-ulnar joint, and a novel method of percutaneous pinning by creating two triangles in two planes by using six k-wires (1.6 mm) by encircling the metaphysis without interfering with the radio-carpal joint. Metaphyseal collapse is prevented by the role of k-wires such as the steel scaffolding in cement concreting, thereby maintaining the congruity of the radio-carpal joint and negative ulnar variance. Excellent and good results come to 87%. The patients can return to their original employment within 3 to 6 months in contrast to the other methods.