Use of Surgical Adhesive Tape to Maintain Tension on Intrafocal K-Wires for Easy Reduction and Fixation of Complex Intra-Articular Distal Radius Fractures

Jonathan M French,Harpal S Uppal,Angelos Assiotis

doi:10.7759/cureus.12427

Jonathan M French, Harpal S Uppal + Show 1 more

Open Access

https://doi.org/10.7759/cureus.12427

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Journal: Cureus	Publication Date: Jan 2, 2021
Citations: 1	License type: cc-by

Affiliation: Bristol Royal Infirmary

Abstract

Maintaining reduction during fixation of complex intra-articular distal radius fractures with dorsal comminution can be challenging. We describe an operative technique where reduction is achieved with temporary intrafocal Kirschner wires (K-wires), and held using surgical adhesive tape wrapped around the hand, whilst a volar plate is applied to achieve rigid fixation. This is a simple, inexpensive method used at our institutions which allows fixation of these fractures without the need for an operative assistant.

Highlights

Distal radius fractures with dorsal angulation, comminution, and/or intra-articular extension are often challenging injuries to treat
The use of intrafocal Kirschner wires (K-wires) to aid internal fixation of the distal radius has previously been described in the literature [1,2,3]
The order of wire insertion is left to the discretion of the surgeon, but in our practice, we routinely reduce the styloid fragment first, apply the first wrap of adhesive tape to the hand, and reduce the dorsal tilt

Summary

Introduction

Distal radius fractures with dorsal angulation, comminution, and/or intra-articular extension are often challenging injuries to treat. We present a case to demonstrate our technique that builds on the above, with novel use of equipment It is a simple, cost-effective method allowing reduction and fixation of complex distal radius fractures with dorsal displacement and comminution, with or without an intra-articular component, by a single surgeon. The order of wire insertion is left to the discretion of the surgeon, but in our practice, we routinely reduce the styloid fragment first, apply the first wrap of adhesive tape to the hand, and reduce the dorsal tilt This construct is stable enough that the hand can be rotated freely and placed flat on the table, without interference from the protruding wire ends, and without the need for an assistant in order to maintain reduction. The wires are subsequently removed and stability assessed on the table

Discussion

Conclusions

Disclosures

Stohr KK