Percutaneous Distal Radius-Ulna Pinning of Distal Radius Fractures to Prevent Settling

Abstract

Purpose To evaluate the clinical and radiological outcomes of distal radius fractures treated by percutaneous fixation using distal radius ulna pinning and to assess its effectiveness especially for preventing fracture settling. Methods We retrospectively reviewed 18 distal radius fractures (15 AO type A2 and 3 AO type Cl). Range of motion and Disabilities of the Arm, Shoulder, and Hand scores were evaluated. We measured radiographic parameters at the final follow-up and compared them with those on immediate postoperative x-rays. Results All fractures united and average time to initial healing was 6.9 weeks (range, 6-7 wk). Average follow-up was 29 months (range, 26-43 mo). Average wrist flexion and extension were 70 degrees and 65 degrees, respectively. Average forearm supination and pronation were 82 degrees and 83 degrees, respectively. Average pain score was 1.2 and average Disabilities of the Arm, Shoulder, and Hand score was 13. Mean difference of ulnar variance, volar tilt, and radial inclination between immediate and final follow-up x-rays was 0.7 mm, 1 degrees, and less than 1 degrees, respectively. Conclusions Percutaneous fixation of distal radius fractures using distal radius-ulna pinning had favorable radiologic and functional outcomes and was effective in preventing fracture settling during initial healing in unstable extra-articular fractures and some simple sagittal split intra-articular fractures. Copyright (C) 2014 by the American Society for Surgery of the Hand. All rights reserved.