Casting versus percutaneous pinning for extra-articular fractures of the distal radius in an elderly chinese population: a prospective randomised controlled trial

Abstract

We carried out a prospective randomised controlled clinical trial to compare the functional and radiological outcomes of casting with percutaneous pinning in treating extra-articular distal radial fracture in an elderly Chinese population. Sixty patients were randomly allocated by sealed envelopes to either a 'Cast' group (n = 30) or a 'K-wire' group (n = 30). All patients were available for final follow-up assessment. The radiological outcomes in terms of dorsal angulation, radial inclination and radial length were statistically significantly better in the K-wire group, whereas the Mayo wrist score and quality of life, healing rate, healing time, and complications were similar. The functional outcomes and quality of life were not affected by the treatments. Both treatments had a very low rate of complication and high healing rates.

Percutaneous pinning of fractures of the distal radius

“…These were the three studies with the shortest follow up and the fewest patients. Another later randomised study also found no advantage from pinning [19].…”

Closed Reduction, Percutaneous Kirschner Wire Fixation and Cast Immobilisation of Distal Radius Fracture- A Prospective Observational Study

“…43 There are few disadvantages of percutaneous pinning like the fear of pin tract infection, besides another minor procedure is required for their removal. 44 Randomised trials [45][46][47] and a systematic review 48 showed that percutaneous pinning across fractures was associated with improved anatomical outcome and minor complications compared with casting. The improved radiological outcomes did …”

Functional, Clinical and Radiological Outcome of Extra Articular Distal End Radius Fracture in Elderly Patients, Closed Reduction and Cross K-wiring Versus Conservative Management (Closed Reduction and Casting)

“…Maintenance of satisfactory alignment is difficult. 6,7,8,9 Recent studies indicate high rate of re-displacement, reangulation and remanipulation following closed reduction and cast immobilization. 8,9 Supplementary percutaneous K-wire fixation resulted in a significantly better maintenance of the alignment of the completely displaced fractures of the distal radius.…”

“…6,7,8,9 Recent studies indicate high rate of re-displacement, reangulation and remanipulation following closed reduction and cast immobilization. 8,9 Supplementary percutaneous K-wire fixation resulted in a significantly better maintenance of the alignment of the completely displaced fractures of the distal radius. [10][11][12][13][14][15] Complications are known to occur in both the groups 13,14 (close reduction and cast immobilisation and close reduction and k-wiring).…”