Treatment of Distal Radius Fractures with Intrafocal (Kapandji) Pinning and Supplemental Skeletal Stabilization

Abstract

The technique of intrafocal pinning was originally described by Kapandji. This technique, along with the addition of supplemental external or internal bridging fixation, can be performed quickly with minimal soft tissue damage. This technique is indicated for the treatment of unstable extra-articular or minimally displaced intra-articular fractures of the distal radius. Studies demonstrate that young patients with displaced extra-articular distal radius fractures and minimal comminution can be treated by percutaneous intrafocal pin fixation alone, whereas, patients over 55 years of age and younger patients with comminution involving two or more surfaces of the radial metaphysis (or > 50% of the metaphyseal diameter) require bridging fixation besides percutaneous pin fixation. The use of this technique achieves the goal of surgical treatment of distal radius fractures: restoration of hand and wrist function through the restoration of alignment and articular surface congruity.