Radiological and Functional Outcome of Displaced Colles’ Fracture Managed with Closed Reduction and Percutaneous Pinning: A Prospective Study

Abstract

Background: Displaced Colles’ fractures are treated by manipulation and below elbow cast application. Malunion is a common complication, resulting in pain, mid-carpal instability, and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique that helps prevent displacement of the fracture, thereby minimizing complications. This study aims to assess the amount of collapse after closed manipulation and percutaneous pinning with Kirschner wires (K-wires) and its correlation with the functional outcome of the wrist after union.Methods: A prospective study was conducted from May 2015 to May 2016 in a tertiary orthopedic center. Ninety patients (60 females, 30 males) with an average age of 54.93 years with Type II fractures underwent closed manipulation and percutaneous pinning with crossed K-wires as the primary procedure. Serial radiographs were taken to document the amount of collapse. The functional outcome was assessed using the Cooney Wrist Score.Results: At the final follow-up at six months, the collapse in the mean dorsal angle was 0.94 and mean ulnar variance was 0.51. Functionally, 48 patients (53.33%) had an excellent outcome, 36 patients (40%) had a good outcome, and six patients (6.67%) had a fair outcome.Conclusions: Displaced Colles’ fractures should be reduced and stabilized with percutaneous K-wires to achieve an excellent functional outcome.

A comparative evaluation closed reduction with percutaneous K-wire fixation versus closed reduction of extra articulur fracture of distal end of radius

“…This finding corroborates with the finding of venkatesh RR et al [11] So K -wire fixation group has better and statically significant anatomical reduction. This finding is supported by the work of Panthi s et al and stein AHJr et al [13,14] . We have observed that there was significant difference in the range of movement in two group which is supported by the work of Mohamaed F et al and Venkatesh RB et al [11,15] Range of movement like palmer flexion, dorsal flexion, supination and pronation, ulnar deviation and redial deviation are significantly better in K-wire fixation group.…”

Radiological assessment of collapse of distal end radius fracture followed by close reduction and cross k wire fixation

“…Among these, 0.5 mm, 1 mm and 2 mm collapse of radial inclination was seen in 51.11 percent, 13.33 percent and 2.22 percent of the patients respectively. Panthi et al [14] , in their study, made radiographic measurements using a goniometer to assess the amount of collapse. The preoperative mean dorsal angle and the mean ulnar variance were 22.33 and 3.66, respectively.…”

Perioperative management of distal radius fractures

“…This is a metaphyseal fracture of the distal radius that typically occurs 2.5cm proximal to the carpal articulation which presents with dorsal displacement and angulation as well as radial shortening of the distal radial fragment ( Panthi et al 2017 ). This fracture pattern is classically described on lateral plain film X-rays of the wrist as a ‘Dinner Fork’ deformity and is associated with an ulnar styloid fracture.…”

“…Typically, Colles’ fractures are low energy, intra-articular and extra-articular distal radius fractures which occur due to a fall on the extended wrist. Colles’ fracture and similar variations are the most common fracture of the distal radius in adults ( Panthi et al 2017 ).…”