EXTERNAL FIXATOR SUPPLEMENTED BY K-WIRES IN MANAGEMENT OF COMMUNITED INTRA-ARTICULAR FRACTURES OF DISTAL END RADIUS

Abstract

Purpose of study: Aim was to evaluate the functional outcome of External fixation supplemented by K-wire fixation in communited fractures of lower end radius and compare the outcome in closed and open fractures treated by this method.

Methods: External fixation along with K-wire fixation was done in 25 consecutive patients (mean age-41.9 years; range-20 to 72 years). According to Frykman’s classification, there were 3 Type VII fractures and 22 Type VIII fractures. 15 fractures were closed type, 4 were Open grade I, 4 were Open grade II and 2 were Open grade III according to Gustilo and Anderson classification. The mean follow-up period was 14.1 months (range- 6 to 25 months).

Results: The mean union time was 7 weeks (range-5 to 8 weeks). Mean dorsiflexion was 37.6 degrees, mean palmar flexion was 44.4 degrees, mean ulnar deviation was 16.2 degrees, mean radial deviation was 14.2 degrees, mean supination was 73 degrees and mean pronation was 79 degrees. Comparison of union time, dorsiflexion, palmarflexion, ulnar deviation, radial deviation, supination and pronation between closed, Open grade I, Open grade II and Open grade III fractures revealed no significant difference. Significant radial shortening was observed in patients with open fractures (P=0.004). 1 patient developed schanz pin tract infection and late distal radioulnar joint subluxation was seen in 4 patients.

Conclusion: Supplementation of External fixator with K-wires is an effective method for treating both closed and open fractures of distal end radius however; radial shortening is seen in some cases with open fractures.