TWO PROCEDURES FOR KIRSCHNER WIRE OSTEOSYNTHESIS OF DISTAL RADIAL FRACTURES
| Autor: | U. Pfister, C. A. Müller, T. Boll, P C Strohm |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiography Colles' Fracture Radial fractures law.invention Fracture Fixation Internal Fixation (surgical) Postoperative Complications Randomized controlled trial law Humans Medicine Orthopedics and Sports Medicine Kirschner wire Aged Aged 80 and over Fracture Healing Osteosynthesis business.industry Colles' fracture General Medicine Middle Aged medicine.disease Surgery Orthopedic surgery Female business Bone Wires |
| Zdroj: | The Journal of Bone and Joint Surgery-American Volume. 86:2621-2628 |
| ISSN: | 0021-9355 |
| Popis: | Background: The treatment of displaced Colles-type fractures of the distal part of the radius remains a challenge. Two procedures for closed reduction and Kirschner wire osteosynthesis of these fractures were compared in a prospective randomized study. Methods: One hundred consecutive patients with a Colles fracture of the distal part of the radius (AO classification 23-A2, 23-A3, or 23-C1) were treated over an eighteen-month period. One group was managed with the conventional method, described by Willenegger and Guggenbuhl in 1959, in which two Kirschner wires are introduced into the styloid process of the radius. The other group was treated with the Kapandji method, as modified by Fritz et al., in which two Kirschner wires are inserted into the fracture gap and a third is placed through the styloid process. Postoperative care was standardized for both groups and carried out according to a strict procedure. Forty patients who had been operated on according to the modified Kapandji method and forty-one treated with the Willenegger technique were available for follow-up, for a follow-up rate of 81%. The follow-up assessment was performed with a modified version of the Martini score. Results: The median time to follow-up was ten months (range, six to twenty months). The results as assessed with the Martini score were, on the average, good to very good for the patients treated with the Kapandji method and satisfactory to good for the patients treated with the conventional Kirschner wire fixation. The duration of radiographic exposure was significantly shorter with the Kapandji method than with the Willenegger technique. Conclusions: Conventional Kirschner wire fixation remains a good method of osteosynthesis for the treatment of displaced fractures of the distal part of the radius. We found both the functional and radiographic outcomes of the Kapandji method to be significantly better than those of the Willenegger technique. Level of Evidence: Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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