Orthopaedic Surgery (Oct 2023)

Comparison of Modified K‐wire Fixation with Open Reduction and Internal Fixation (ORIF) for Unstable Colles Fracture in Elderly Patients

  • Lin Zhang,
  • Haoming Jiang,
  • Jin Zhou,
  • Jingti Jing

DOI
https://doi.org/10.1111/os.13847
Journal volume & issue
Vol. 15, no. 10
pp. 2621 – 2626

Abstract

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Objective Open reduction and internal fixation (ORIF) is the standard treatment of unstable Colles fracture among the elderly. Modified percutaneous K‐wire fixation is becoming increasingly popular in recent years. However, there is controversy concerning its appropriate use. This study aimed to compare the early safety and efficacy of the two different treatments and provide an alternative method for the treatment of unstable Colles fracture among the older population. Methods Electronic medical records of 60 consecutive unstable Colles fractures patients who underwent surgery from June 2019 to October 2021, by modified percutaneous K‐wire fixation (30 patients) or ORIF (30 patients), were reviewed retrospectively. All cases were followed up for 3 months. The outcomes of patients were assessed with operation time, intraoperative blood loss, visual analog score (VAS) for wrist joint pain, palmar tilt (PT), radial inclination (RI), radial height (RH), Gartland–Werley score, total hospitalization costs, hospital stays, postoperative complications, and patient subjective satisfaction. General patient information was also collected. Independent Student's t‐test or Mann–Whitney U test were used to compare continuous data. Pearson's chi‐square test or Fisher's exact test were used to analyze the categorical data. Results The operation time and intraoperative blood loss were significantly shorter in the K‐wire group than in the ORIF group (p 0.05). There were no significant differences in the PT, RI, and RH between the two groups preoperatively and at 1, 4, and 8 weeks postoperatively (p > 0.05). Patients in the K‐wire group had significantly shorter hospital stays and lower total hospital costs (p 0.05). Compared with the ORIF group, postoperative complications were lower, and patient subjective satisfaction was higher in the K‐wire group, but there were no significant differences (p > 0.05). Conclusions Modified percutaneous K‐wire fixation in the treatment of unstable Colles fracture among the elderly is a safe, effective, rapid, and minimally invasive surgical option for surgeons.

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