Role of percutaneous pinning and cast application in extra-articular and simple intra-articular management of distal radius fractures: A clinical study

Abstract

Background: Distal end radius fracture is a common fracture seen in the routine orthopedic practice. Although most of these fractures are managed by cast application, the loss of reduction and malunion rates are high. Closed reduction, percutaneous pinning, and cast application offers a simple method of managing these fractures. This study was done to evaluate the functional and radiological of extra-articular and simple intra-articular distal radius fractures using closed pinning and cast immobilization. Materials and Methods: A prospective study of 73 skeletally mature patients with displaced extra- and intra-articular fractures without significant comminution was done. Closed reduction was done under anesthesia and fixation done with 2 or 3 Kirschner-wires followed by cast for 6 weeks. Final follow-up was done after 6 months using Sarmiento's modification of Lindstrom criteria and demerit point system of Gartland and Werley. Results: The fracture united in all the 73 patients. The average preoperative radial height changed from 2.7 to 13.2 mm postoperatively and a final value of 10.9 mm. The average volar tilt changed from −11.25° preoperatively, 12.1° postoperatively, and 9.7° at the final follow-up. Only two patients had a significant loss of reduction. Pin tract infection, joint stiffness, pin migration, and complex regional pain syndrome were the major complications. Conclusion: Closed reduction, percutaneous pinning, and cast immobilization is a technically simple and an effective method for managing displaced extra-articular and simple intra-articular distal radius fractures.

Keywords

• cast application
• closed reduction
• distal radius fractures
• percutaneous pinning