[Long-term results after Kirschner wire pinning of distal radius fractures].

BACKGROUND: The purpose of this study was to investigate the outcome after K-wire pinning of distal radius fractures with a minimum follow-up period of 5 years. PATIENTS AND METHODS: A total of 189 patients with an isolated fracture of the distal radius were treated between 1998 and 2002 and 100 were evaluated at an average of 5.6 years after the surgery. At the final follow-up examination all patients were assessed clinically and bilateral radiographs were taken.
RESULTS: Of the patients 37 had an A type fracture, 8 a B type and 55 a C type according to the AO classification and 86% achieved good to excellent results based on the Gartland and Werley and Disability of Arm, Shoulder, Hand (DASH) scores. Patients were divided in to two groups. Group A included patients with fractures with a primary palmar inclination greater than -20° (range -20° to 10°) and group B with fractures with a primary palmar inclination less than -20° (range -45° to -20°). Secondary loss of reduction was significant higher in group B compared to group A (group B: 8.3°, group A: 1.6°, p <0.05). In 8 out of 11 patients of group B an osteoporosis was found. Functionally no difference was detected between the two groups. Radial shortening of over 4 mm resulted in a significant reduction (36%) of prosupination and supination. No other influence of the radiological results on the functional or subjective outcome was found. Superficial infection of the K-wire occurred in 6 cases, whereas early K-wire removal was performed in 2 cases, 8 patients complained of dysesthesia in the area of the superficial radial nerve and 5 patients developed an early stage of the complex regional pain syndrome.
CONCLUSION: K-wire pinning cannot be routinely recommended. However, in cases of A2, A3 and C1 fractures, a primary dorsal dislocation of less than -20° and in patients without low bone mineral density, K-wire pinning leads to a high rate of radiological, functional good results.