Outcome of comminuted distal-end radius fracture managed with Ulno-Carpal and distal radius stabilization using percutaneous K-wires

Abstract

Background: Distal radial fractures account for up to 20% of all fractures treated in emergency departments, many are not “completely exempt from pain” after treatment. Several treatment modalities have been described with their own merits and demerits. Stabilization of ulno-carpal articulation is an effective method to prevent radial collapse and other complications associated with external fixator during healing, and hence this study has been designed to get a solution with good outcome and minimal complication. Materials and Methods: A prospective study on eighty patients of comminuted intra-articular fracture of the lower end of the radius, between 30 and 65 years of age, irrespective of sex, treated by closed reduction and ulno-carpal stabilization maintaining ligamentotaxis and distal radius percutaneous K-wires fixation and a well-molded above-elbow Plaster of Paris cast for 4 weeks followed by removal of K-wire and below-elbow cast for 2 weeks, has been presented. Patients were evaluated at 6-month follow-up and functionally by Sarmiento's modification of Lindstrom criteria and Gartland and Werley's criteria. Results: Excellent results were seen in 85%, good in 11.25%, and fair in 4.75% of the cases. Complications observed were malunion (n = 2), subluxation of the inferior radio-ulnar joint (n = 2), Sudeck's osteodystrophy (n = 1), and posttraumatic arthritis of the wrist (n = 2). Conclusion: The closed reduction and percutaneous K-wire fixation is a least invasive, safer, and effective method to maintain the reduction, prevent radial collapse during healing, and maintain the stability of the distal radio-ulnar joint even when the fracture is grossly comminuted, intra-articular, or unstable.