Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
CATA, Ezequiel et al. Unstable extra-articular distal radius fractures: Percutaneous Kirschner wires (Kapandji) versus locked volar plating. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2011, vol.76, n.1, pp. 5-13. ISSN 1852-7434.
Background: The purpose of this study is to compare the radiographic behavior of unstable extra-articular distal radius fractures treated with percutaneous Kirschner wires (Kapandji technique) with those treated by open reduction and internal fixation using locked volar plates. Methods: We retrospectively evaluated 58 patients with 62 distal radius fractures. 31 fractures were stabilized with percutaneous Kirschner pins and 31 with locked volar plates. Patients' age averaged 62 years. 39 fractures were caused by low-energy trauma. Radiographic controls were performed pre-operatively, immediately postoperatively, at six weeks, and at four months. Absolute radial height displacement, absolute radial inclination displacement, and absolute volar angulation displacement were assessed. Results: Union was achieved in all fractures. There was a statistically significant loss of radial inclination (p = 0.0001), radial height (p = 0.0001) and volar angulation (p = 0.0003) in fractures treated with percutaneous Kirschner wires and plaster. Conclusions: Volar locked plates are more reliable than Kirschner wires in preserving the reduction achieved intraoperatively in unstable extra-articular fractures of the distal radius. The use of locked volar plates is recommended in young active patients; maintaining the anatomic reduction will reduce the degree of secondary arthritis, and result in less long term pain and functional impairment.
Palabras clave : Distal radius; Extra-articular fractures; Percutaneous Kirschner wires; Locked volar plate.