A randomized prospective study of 40 patients who presented to a tertiary care hospital in Gwalior with fracture of distal end of radius

Abstract

Background: Distal radius fractures are among the most common fractures of the upper extremity. The incidence of distal radius fractures increases with increasing age, but till now no standard protocol for treatment has been established for different age groups. The challenge of treating a displaced distal fracture is well known to the clinician. Perhaps no fracture in the body is as obiquitous and fraught with potential complications as the distal radius fracture. We conducted a study with the aim to compare the result of close reduction with cast alone and close reduction, K-wire fixation with cast application in fracture of distal radius. Material and Method: A total of 40 patients presented to GR Medical College, Gwalior from September 2005 to September 2006 with distal radius fracture were included in the study and were treated with either closed reduction with below elbow pop cast application or close reduction with K-wire fixation with below elbow pop cast application. These patients were followed up for at least 6 months after injury. Functional results were evaluated according to Demerit system of Gartland and Werely as modified by Sarmiento et al. Result: The functional outcome was excellent in 10%, good in 60% and fair in 30%cases treated with K-wire fixation and cast application, compared to excellent in 5%, good in 35%, fair in 50% and poor in 10% cases treated with close reduction and cast application. The radiological outcome was excellent in 25%, good in 65% and fair in 10%cases treated with K-wire fixation and cast application, compared to excellent in 10%, good in 50 %, fair in 30 % and poor in 10 % cases treated with close reduction and cast application. Conclusion: Closed reduction with percutaneous K-wire fixation resulted in better functional and radiological outcome in our series followed up for at least 6 months when compared to closed reduction and cast application alone, probably as the K-wires prevented angulation and collapse which can occur with cast alone when swelling subsided.