A COMPARATIVE STUDY OF TREATMENT OF COLLES FRACTURE - CLOSED REDUCTION AND PERCUTANEOUS KIRSCHNER WIRE FIXATION WITH PLASTER CAST VERSUS CONVENTIONAL PLASTER CAST IMMOBILISATION

Abstract

Anil Kumar S. D1

BACKGROUND Displaced Colles fracture are generally treated by manipulation and below elbow cast application. Malunion is a common complication resulting in pain, midcarpal instability and posttraumatic arthritis. Fracture stabilisation by pinning with K-wire is an easy and less traumatic procedure, which helps to prevent dislodgement of the fracture thereby minimising complications. The aim of study is to evaluate functional and anatomical results of the Colles fractures treated by two methods a) closed reduction and percutaneous Kirschner wire (K-wire) fixation and plaster cast, b) closed reduction and immobilisation with short-arm plaster cast for 6 weeks.
MATERIALS AND METHODS A randomised prospective comparative study was done from August 2013 to July 2015 on 60 patients with Colles fracture attended ortho OPD Mount Zion Medical College, Adoor. All patients completed followup. The group treated by closed reduction and percutaneous K-wire fixation with plaster cast (30 in number) formed as Colles Group X. The group treated by closed reduction and short-arm cast for 6 weeks (30 in number) formed as Colles group Y.
RESULTS Union time for most of the fracture is 6-9 weeks. Anatomical function result satisfactory 70% with Colles group X, Colles group Y, it is 30%. Functional result satisfactory 80% in Colles group X. It is only 20% in Colles group Y. Complications seen much more in group Y than group X. Sarmiento and Latta’s criteria was used to evaluate the progress.
CONCLUSIONS
1. Good anatomical position in percutaneous pinning with K-wire.
2. Good functional results in percutaneous pinning with K-wire.
3. Late collapse at fracture site is less in percutaneous pinning with K-wire.

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