OUTCOME ANALYSIS OF DISTAL RADIUS FRACTURES TREATED WITH K-WIRES VS CASTING

Abstract

Background Distal radius fracture has long been treated by closed reduction and casting . Although casting sufces in a proportion of cases, it may fail to maintaining the reduction is usually a problem. Hence, in a majority of cases, with cast satisfactory reduction can lost resulting in a poor anatomical and in some cases functional outcome. Percutaneous K-Wire xation1-3 is a simple way of providing additional stability to immobilization in casting an unstable fracture of distal radius in which acceptable anatomical reduction is obtainable. The technique is simple, minimally invasive and inexpensive. It is much less intrusive than other methods such as external xation. Though it has its own set of complications e.g. pin tract infection, supercial radial neuropathy etc. It still forms an effective tool in the surgical armamentarium for treatment of distal radius fractures. The present study was conducted at the de Methods partment of orthopaedics Andhra medical college/ king George hospital Visakhapatnam between 2020 and 2021.Sixty patients who fullled inclusion criteria were taken up for study n=60. They were randomly divided into two groups with 30 members each belonging to casting and k-wire xation groups. In Results both treatment methods radial length, ulnar variance, radial angulation are restored to near normal but correction of dorsal tilt is not complete. This is because the fact that volar ligaments are stronger on distraction before relatively 'Z' oriented dorsal ligaments. So, on distraction volar cortex is brought out to length before dorsal cortex preventing full correction of dorsal tilt.Cast immobilization alone could not maintain reduction in unstable fractures resulting in poor anatomical outcome.53% patients of cast immobilization had moderate to severe deformity, compared with only 11.76% patients of K wire and casting group having moderate deformity. At the end of 12 weeks, functional outcomes in the studied both types were almost similar with no signicant difference in DASH scores. At the end of the study, we concluded that Conclusion both the techniques of managements K wire xation and casting and closed reduction and casting gives near equal results in terms of functional outcome. Better anatomical reduction and maintenance of reduction can be expected with K wire xation and casting group.