High rate of complications associated with extrafocal kirschner wire pinning for distal radius fractures

Article Article scientifique Article High rate of complications associated with extrafocal kirschner wire pinning for distal radius fractures eng 2008 author Van Aaken Jan 685497 author Beaulieu Jean-Yves 0000-0002-5537-7505 679969 author Della Santa Dominique 112213 author Kibbel Olivier André 66887 author Fusetti Cesare 565569 160-166 10.1016/j.main.2008.05.005 18678519 1297-3203 Kirschner wire (K-wire) fixation is a common technique aimed at treating unstable distal radius fractures. We report our experience with extrafocal K-wire fixation in the treatment of unstable distal radius fractures in 34 patients (AO classification: 10 A2, 5 A3, 14 C1, and 5 C2). The patients' median age was 63 years (range, 16-87 years). K-wires remained in place for a median duration period of 42 days, and a splint was applied during 44 days in median. The median follow-up was 2.5 years (range, 1.3-5 years). At the final follow-up examination, all patients were assessed clinically and bilateral radiographs were taken. The median final range of motion was 69 degrees /64 degrees for extension/flexion, 88 degrees/82 degrees for pronation/supination and 36 degrees/21 degrees for ulnar/radial deviation. Grip strength was 81% of the contralateral side. Using the Gartland-Werley score, 12 patients (35%) had excellent results, 17 (50%) good, and five patients (15%) had fair results. The median final radiographic dorsal tilt was 4.5 degrees (range, 0-14 degrees) and 79% of patients had a loss of volar reduction (median 8 degrees). Radial inclination was in median 20 degrees (range, 10-32 degrees) with 82% of the patients with loss of reduction (median 5 degrees). Radial shortening was in median 0.9 mm (range, -2 to +5 mm) and 62% of patients had median loss of radial length of 1.1mm. Radial shortening was the major source of pain due to ulnar impingement. We found a high complication rate, with 15 patients (44%) suffering from at least one of the 30 reported complications. We did not find any direct correlation between radiographic results and mobility. Although good clinical outcome may be obtained, K-wire fixation cannot be routinely recommended. Adolescent Adult Aged Aged, 80 and over Bone Wires/adverse effects Female Follow-Up Studies Fracture Fixation, Internal/adverse effects/instrumentation Hand Strength Humans Joint Instability/surgery Male Middle Aged Radius Fractures/radiography/surgery Range of Motion, Articular Wrist Joint/radiography/surgery Dewey 617 57 Département de chirurgie 222 false 74 Chirurgie orthopédique et traumatologique 98 Chirurgie de la main 27 4 7b28704a-8200-4865-849a-8afdb4d1f051 Article (Published version) Restricted 1-s2.0-S1297320308000425-main.pdf 453945 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

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High rate of complications associated with extrafocal kirschner wire pinning for distal radius fractures	Chirurgie de la main			2008	576	0

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Kibbel, Olivier André