the study of extra articular type of fractures of distal end radius in adults, their management with modalities of treatment involving closed reduction and cross K WIRE pinning and below elbow cast and its comparison with intrafocal pinning method of Kapandji and the relative complications.
Material and Method: All procedures were done in the operation theater under short general or i.v. regional anesthesia with monitoring of patient’s pulse, blood pressure, SPO2 and ECG recording after aseptic preparation of the effected extremity. The patient was placed on a radiolucent table in supine position. Complete visualization of the fracture pattern of the involved bone was done with the help of C-Arm fluoroscopy in antero-posterior and lateral views.
Results: Dorsal tilt correction evaluation in cases by cross K wire method was Grade I (00-10,20-100) in 24 cases (96%) and Grade II (110-140,>150) in 1 case (4%) and that in Kapandji method was Grade I (00-10,20-100) in 18 cases (72%) and Grade II (110-140,>150) in 7 cases (28%). The cross K wire method is better than Kapandji method with respect to dorsal tilt correction with p=0.0243. Radial shortening evaluation in cases by cross K wire method was Grade I (<3, 3-6) in 24 cases (96%) and Grade II (7-11, >12) in 1 case (4%) and that in Kapandji method was Grade I (<3, 3-6) in 19 cases (76%) and Grade II (7-11, <12) in 6 cases (24%). The cross K wire method is better than Kapandji method with respect to radial shortening with p=0.042.
Conclusion: In cases with dorsal commination treated with Kapandji fixation dorsal tilt ecurrance was noted post reduction as orsoventral K wire had poor hold in near cortex. Despite of these results we suggest method of chaise in these fractures treatment should be made according to judgement of individual surgeon.