Treatment of distal radial fractures with antegrade intra-medullary Kirschner wires

Abstract

The treatment of unstable Colles-type distal radial fractures remains a challenge. A prospective study was conducted to evaluate the outcomes of the treatment of unstable distal radial fractures using antegrade intra-medullary K-wires. Twenty-eight Colles-type distal radial fractures were selected excluding comminuted intra-articular and Barton’s fractures. The blunt tips of intra-medullary K-wires were introduced in an antegrade direction to support the subchondral bone of the distal fragment. The scoring system of Green and O’Brien modified by Cooney et al. was used for the final clinical evaluation. The radiological outcomes were evaluated using the scale proposed by Stewart et al. After a mean follow-up of 34 months (range 14–46), 17 patients were rated clinically excellent, seven good, three fair and one poor. The mean loss of radial height, radial inclination, volar tilt and ulnar variance was 0.9 mm, 1.9°, 0.5° and 0.4 mm, respectively. These results were comparable with the values reported in other pinning studies. Only one patient complained of skin irritation and painful bursitis in the forearm; otherwise, no complications related to tendon or nerve injury were encountered. One patient had protrusion of K-wire into the wrist joint. The technique proved to be effective in maintaining reduction in distal radial fracture with low rate of soft tissue complications.