P. Adnan Siddique1, Sasikumar Sasidharan2, Prateek Chandak3
BACKGROUND
Closed reduction with plaster of Paris (POP) cast for extra-articular distal radius
fractures was an accepted method of treatment worldwide. But the maintenance
of reduced fracture fragments was unpredictable. Closed reduction and ‘K’ wire
fixation with casting was also recommended widely. There was no definite option
prescribed for either of the methods. In this study, we wanted to compare the
final outcome of management of the distal radius fractures in adults with closed
reduction and POP casing versus closed reduction with percutaneous K-wiring.
METHODS
A prospective, randomized, and comparative study was conducted on the final
outcome of two methods of treatment for the fractures of distal end of radius.
One method (Group A of 23 patients) consisted of closed reduction and POP
casing and the other (Group B of 23 patients) consisted of K-wiring under C arm
(23 patients in each group). Radiological and functional parameters were
compared at fixed intervals for 15 months and final outcome scores were
correlated and compared using Gartland and Werley functional scoring system.
RESULTS
In group A, AO type 2R3A2.1 fractures were observed in 03/23 (13.04 %)
patients and 04/23 (17.39 %) in Group B patients. Type 2R3A2. 2 fractures were
observed in 05/23 (21.73%) of the group A patients and 07/23 of the group B
patients. Type 2R3A2.3 fractures were observed in 15/23 of the group A and
12/23 (52.17%) of the group B patients. Both the methods of treatment were
correlating well with the various variables.
CONCLUSIONS
Closed reduction with percutaneous K wiring and below elbow cast application
was a simple, minimally invasive technique that provided added stability and
functional outcome with respect to treatment of extra-articular distal radius
fracture. The conventional method of closed reduction and POP cast was closely
correlating with the K wire immobilization method. There was no significant
statistical difference between the two methods in the functional outcome after
treatment of distal end radius fractures.
