CLOSED REDUCTION AND PERCUTANEOUS WIRING IN TREATMENT OF DISPLACED COLLES’ FRACTURE
Basrah Journal of Surgery,
2016, Volume 22, Issue 2, Pages 57-62
AbstractAbstract Fractures of distal radius including colles’ fracture are common and account for one sixth of all fractures in adult. Achievement of good realignment of the fracture is essential from a functional and cosmetic point of view. The modalities for treatment of this treatment are varied and much confusion is present as regards appropriate treatment of various fracture types. This study aimed to compare functional and radiological outcome of percutaneous pinning procedure with traditional cast immobilization in patient with displaced colles’ fracture. This is prospective study was carried out from October 2013 to October 2014. Forty cases of displaced colles’ fracture were studied. Their age was 20 to 70 years, they were divided into two groups 20 cases were treated by closed reduction with percutaneous k-wire fixation and other 20 cases were treated by closed reduction with conventional POP casting. The results were evaluated and compared both clinically and radiologically. Patients treated with percutaneous K-wiring had statistically significant improvement both functionally (p value=0.032) and radiologically (p value=0.019) compared with conventional casting group. In group of closed reduction and K- wire fixation, functional evaluation was done according to Gartland and Werley scoring system showed excellent results in 4 patients (20%), good result in 10 (50%), fair results in 5 (25%) patients and poor result only in 1 patient (5%). The anatomical evaluation using Sarmiento’s Criteria showed excellent results in 3 patients (15%), good results in 10 (50%), and fair results in 7 (35%) patients and there was no patient with poor result (0%). While in group of closed reduction and casting, functional evaluation showed excellent results in 1 patient (5%), good results in 4 (20%), fair results in 13(65%) patients and poor result in 2 patients (10%) and anatomical evaluation showed excellent results in 1 patient (5%), good results in 3 (15%), and fair results in 14 (70%) patients and poor results in 2 patients (10%). In conclusion, closed reduction with percutaneous k-wire fixation of displaced colles’ fracture is a minimally invasive technique which provides extra stability in the treatment of displaced colles’ fracture with good clinical and radiological outcome. Conservative treatment is to be considered in elderly patients and where resources of implants and radiological control are limited.
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