An Outcome Study of DERFs Managed by Close Reduction & Immobilization Vs Close Reduction by Intra Focal Pinning (Kapandji Technique)

Abstract

Objective: The study is aimed at comparing the outcome of management of DERFs by close reduction and immobilisation by POP cast (CRIPOP) vs. close reduction and immobilisation by intrafocal pinning (K-wire), Kapandji technique. Material and method: 80 patients with DERFs (Frykman I&II/AO23AR) aged 19–68 years, both sexes, and sides (left or right) of involvement were studied at the Department of Orthopaedics, HIMS, Sitapur (U.P.), India, after getting clearance from the institute's ethical committee. The individual's identification, history, clinico-radiological evaluation (pre- and post-op), and follow-up were recorded in a pretested proforma. A standard protocol of pre- and post-operative care and physiotherapy was followed by all patients, irrespective of group. Results: To assess the functional outcome, cases were followed up at 6 weeks, at the time of removal of POP, at 12 weeks, and at 24 weeks. The objective assessment was done on parameters like wrist movement, i.e., palmer/dorsiflexion, radial/ulnar deviation, wrist/finger stiffness, supination, and pronation in forearm functions. The functions were compared with other limb functions. Subjective parameters such as pain, ADL, and work-related activities (satisfaction level) were also taken into account. The difference in distribution among groups was insignificant. Other than a pinhole infection and finger stiffness, there was no significant complication. Conclusion: CRIPOP was found to be an equally better option of treatment methodology in respect of functional outcome at 6 months in extra-articular (Fryman types I and II) or AO/OTS (23A2 and 3). The limitation of the study is the small number of cases and parameters to compare. Keywords: DERF, CRIPOP, Kapandji, Focal Pinning