Comparison between closed reduction plaster casting and percutaneous Kirschner wire pinning in the management of distal radius fractures in patients aged 65 years and older

Abstract

Aim: Closed reduction plaster casting (CRPC) and percutaneous pinning (CRPP) remain an important treatment modalities for extra-articular distal radius fractures especially in elderly patients. These two treatment methods have advantages and disadvantages compared to each other. The ideal treatment of extra-articular distal radius fractures is still debatable. We aimed to retrospectively evaluate the clinical and radiological results after CRPC and CRPP for the treatment of distal radius fractures in the patient population over 65 years of age.
 Material and Method: Between 1 January 2015 and 1 January 2019, patients older than 65 years of age who presented with extra-articular noncomminuted distal radius fractures were retrospectively evaluated. 95 patients diagnosed with distal radius fracture were separated into 2 groups, who were administered the following: CRPC (n:51), CRPP (n:44). We compared the characteristics of the patients, the mechanisms of injury, fracture types and treatment methods, pre-reduction and post-reduction radiological parameters and clinical functions for the two groups. Volar tilt, radial inclination, ulnar variance, and radial length were compared. Clinical results were also compared.
 Results: The mean follow-up period was 19.8 months (range, 12-29 months; SD=11.0) in the CRPC group and 18.6 months (range, 12-26 months; SD=10.9) in the CRPP group. Mean range of motion and grip strength were maintained in both treatment groups at one-year follow-up. There was no statistically significant difference between the groups (p>0.05). There was no statistically significant difference between the groups in terms of the scores evaluating the daily activity, pain and mental status of the patients after the treatment (p>0.05). There are no statistically significant differences between fixation with CRPC and CRPP in terms of clinical and radiological results (p>0.05). 
 Conclusion: Closed reduction plaster casting and closed reduction percutaneous pinning are equally effective in the treatment of extra-articular distal radius fractures in the elderly.