Comparative analysis of closed reduction and percutaneous pinning versus conventional closed reduction with casting in extra-articular fractures of distal end radius

Abstract

Background: Distal radius fractures are very common. Closed reduction and casting are the conventional non-operative treatment option available while plate fixation, external fixation and closed reduction with percutaneous pinning are a few surgical options available to the surgeon.Methods: A prospective comparative study of one year was conducted in the Department of Orthopaedic Surgery. A total of 40 patients of distal radial fracture fulfilling the inclusion criteria and giving their consent for inclusion in the study were randomly allocated to either closed reduction (n = 20) or closed reduction with percutaneous K-wire (20). Patients were followed up to 6 months and radiological and functional outcome was compared between two groups.Results: On global assessment using Gartland and Werley criteria, median score of K-wire group was 7.5 which indicated that majority of patients had score <8, thus indicating a good outcome whereas in closed reduction cast group, median score was 13.50, thus indicating that majority of patients had scores in the fair to poor grade. None of the patients in K-wire group had score above 18, thus indicating that all the patients in this group had shown a fair treatment response. Statistically, the difference between two groups was significant too.Conclusions: The present study thus establishes that the immediate post-operative morphological/anatomical and 6 month functional and morphological outcome of closed reduction with K-wire is better as compared to closed reduction with cast.