The use of percutaneous Kirschner wires [K-wires] and plaster is a popular method of treatment for displaced distal radius fracture. However, multi-database electronic literature review reveals unsurprisingly different views regarding their use.

From August 2002 till June 2004, 280 distal radial fractures were admitted to our orthopaedic department. They were recorded prospectively in the departmental trauma admissions database. We studied the 87 cases treated with the K-wires and plaster technique. They were classified according to the AO classification system. The mean patient age was 53 [5-88] years. The mean delay before surgery was 7 [0-24] days. We studied the complications reported by the attending orthopaedic surgical team. 48 out of 87 patients [55.1%] were reported to have complications.

We analysed the displacement and the pin tract infection, as they were the main reported complications. 28 out of 87 patients [32%] had displacement [9 had further surgery to correct the displacement, 19 did not have any further surgery as the displacement was accepted]. 11 out of 87 patients [12.6%] had pin tract infection [7 needed early removals of the K-wires and systematic treatment]. Further analysis showed no statistically significant relation between the complications rate and the age of the patients, the delay before surgery or the type of the fractures.

We demonstrate a considerable high displacement and infection rate with the use of K-wires and plaster technique for fixation of distal fracture irrespective of the age of the patients, the delay before surgery or the fracture classification. There are other methods for fixation of the distal radial fracture with proven less morbidity which should be considered.

Hospital Episode Statistics [HES] are often used by hospital managers and politicians as a reflection of departmental workload. The accuracy of these data is often questioned. We aimed to ascertain the reliability of this database for trauma admissions.

Between 2002 and 2003, all admissions were recorded by doctors using a separate departmental database. Data were collected during the daily trauma meetings and compared with the HES returns for the same period. 2496 patients were recorded in the trauma admissions database. Overall, 36.4% of the patients were either not recorded by the HES database or wrongly coded in terms of type of admissions or diagnosis.

HES data for all 2496 records was analysed by type of admissions and speciality.4.2% of trauma patients were incorrectly classified as elective or day cases. 2.9% of trauma patients admitted to hospital were not recorded in the HES data as orthopaedic admission.

The accuracy of HES diagnosis coding was tested on 300 records randomly selected by a statistical package. HES recorded the wrong diagnosis in 29.3% of cases. A significant number of trauma cases were not counted in the HES data. This may have significant implications for trauma funding.

HES data does not accurately record diagnosis and therefore can not be used as a research tool for specific injuries. Data recording practice should be changed to improve HES data accuracy.