Aim: To identify the variables associated with poor radiological outcome in the distal radius fractures stabilized with K wires.
Materials &
Methods: All the patients who underwent K wire fixation of distal radius fracture in last 3 years were included in this retrospective study. AO Classification was used to classify the fracture. Immediate post fixation radiographs and radiographs taken just prior to removal of K wires (5–6 weeks) were analyzed to study three radiological parameters (dorsal tilt, radial tilt, ulnar variance). Changes in these parameters were recorded. Results were graded as excellent, good, fair and poor according to the Stewart classification. The results were analyzed against variables like age, sex, AO classification, associated ulnar fracture, number of k wires used, delay in fixation and duration of fixation. Statistical tests were performed to find out variables associated with the poor radiological outcome.
Results: 113 distal radius fractures were analyzed in total. Average age of patients was 56.2 years (standard deviation-19.9) with male to female ratio of 1:2.1. Average loss of radial tilt was 4.12 deg, loss of dorsal tilt was 8.07 deg and change in the ulnar variance was 3.12 mm. We found excellent results in 23.9 %, good result in 56.6%, fair results in 15 % and poor results in 4.4 % of patients.
Age more than 65 years (p value 0.006), comminuted distal radius fracture [A3 or C3 in AO classification] (p value 0.049) and associated ulnar fracture (p value 0.013) were the variables found to have statistically significant correlation with poor radiological outcome.
Conclusion: Age more than 65, comminuted distal radius fracture and associated ulnar fracture are the variables associated with poor stability of K wire fixation in distal radius fracture. Alternative mode of stabilization should be considered to improve the stability of the fracture fixation in these patients.