Reduction with a temporary intrafocal K-wire during internal fixation of distal radius fractures

Abstract

Distal radius fractures with dorsal fragmentation are challenging. Conventional internal fixation techniques involve a dorsal approach with dorsal plating; complications include scarring, stiffness and tendon attrition. I describe a Kirschner wire used in an intrafocal (Kapandji) manner to reduce temporarily and hold fragments during volar locking plate application. The intrafocal wire is inserted into the fracture site at an acute angle; the fragment is levered into position under imaging. The volar locking plate is applied and the wire removed thus avoiding long-term disruption to dorsal structures (Fig. 1). Figure 1 The K-wire is inserted dorsally and levers the dorsal fragment(s) into position while the volar plate is applied.