Abstract
Introduction: There is a controversy regarding the treatment of the intra articular fracture of the distal radius. Plating for anatomical reduction vs the minimally invasive method by mini external device and K wires. We report our experience with the minimal invasive technique.
Materials and Methods: Between January 2003 and march 2005, 43 patients with intra articular fracture of distal radius were treated. 22 females, 16 males were followed. Age range 23–81 (mean 55 years). All cases were uni lateral. 38 patients were followed out of 43 fractures. Causes: 23 fall, 9 RTA, 6 sport accidents. The fractures were classified according the Frykman classification: 5 F3, 6 F4, 6 F5, 9 F6, 5 F7 and 7 F8. Follow up was 6 weeks after treatment and 6 months later. A Lateral and PA views were performed and the angles were measured. The V.A.S. was used to quantify the painful level. The Lidstrom criteria scale was used to evaluate the functional outcome. The surgical procedure was performed on the same day or one day later. In all cases the mini external device of AO (2 threaded rods in the second metacarpal and another 2 rods in the radius) was used. In 20 cases, 1 or 2 K wires were inserted in addition from the radial styloid to stabilize the fracture. The mini external was removed 6 weeks later.
Results: According to Lidstorm criteria, 12 patients (31%) had excellent results, 23 (61%) good, 2 (5.5%) fair and 1 (2.5%) poor outcome. The results of the VAS were good: 33 had less than 3, 4 patients less than 5 and one patient chose the number 9 to quantify his pain. At the follow up, 35 patients restored a very good range of motion (ROM) of the wrist, while 3 patients had markedly reduced ROM. The best outcome is shown in the younger population, except one case, a young man 33 years old, who was unable to return to work 6 months later. Four patients (1%) had a pin tract infection treated by PO antibiotics.
Conclusion: In our hands, the minimally invasive technique seems to be a satisfactory procedure. In the young population, the restoration of the range of motion was very good. The loose of few degrees in the arc of motion in the elderly population didn’t disturb there functional performance. We think that the mini-invasive method is excellent tool for treating intra-articular fractures of the distal radius; the procedure is shorter and there is less chance of infection and less damage to the surrounding tissues.
The abstracts were prepared by Orah Naor, IOA Co-ordinator and Secretary. Correspondence should be addressed to Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
