Restricted accessResearch articleFirst published online 2010-3
Casting versus percutaneous pinning for extra-articular fractures of the distal radius in an elderly chinese population: a prospective randomised controlled trial
We carried out a prospective randomised controlled clinical trial to compare the functional and radiological outcomes of casting with percutaneous pinning in treating extra-articular distal radial fracture in an elderly Chinese population. Sixty patients were randomly allocated by sealed envelopes to either a ‘Cast’ group (n = 30) or a ‘K-wire’ group (n = 30). All patients were available for final follow-up assessment. The radiological outcomes in terms of dorsal angulation, radial inclination and radial length were statistically significantly better in the K-wire group, whereas the Mayo wrist score and quality of life, healing rate, healing time, and complications were similar. The functional outcomes and quality of life were not affected by the treatments. Both treatments had a very low rate of complication and high healing rates.
AzzopardiTEhrendorferSCoultonTAbelaM. Unstable extra-articular fractures of the distal radius: a prospective, randomised study of immobilisation in a cast versus supplementary percutaneous pinning. J Bone Joint Surg Br. 2005, 87: 837–40.
2.
ChungKCWattAJKotsisSVMargaliotZMSHaaseSCKimHM. Treatment of unstable distal radial fractures with the volar locking plating system. J Bone Joint Surg Am. 2006, 88: 2687–94.
3.
ClanceyGJ. Percutaneous Kirschner wire fixation of Colles fracture: a prospective study of thirty cases. J Bone Joint Surg Am. 1984, 66: 1008–14.
4.
CooneyWPBusseyRDobynsJHLinscheidRL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res. 1987, 214: 136–47.
5.
CooneyWPLinscheidRDobynsJ. External pin fixation for unstable Colles’ fracture. J Bone Joint Surg Am. 1979, 61: 840–5.
6.
FernandezDL. Closed manipulation and casting of distal radius fractures. Hand Clin. 2005, 21: 307–16.
7.
FrykmanG. Fractures of the distal radius including sequelae – shoulder–hand–finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function: a clinical and experimental study. Acta Orthop Scand. 1967, Suppl. 108: 3Suppl.
8.
GoftonWLiewA. Distal radius fractures: nonoperative and percutaneous pinning treatment options. Orthop Clin North Am. 2007, 38: 175–85.
9.
GreenDP. Pins and plaster treatment of comminuted fractures of the distal end of the radius. J Bone Joint Surg Am. 1975, 57: 304–10.
10.
HandollHHVaghelaMVMadhokR. Percutaneous pinning for treating distal radial fractures in adults. Cochrane Database Syst Rev. 2007, 183CD006080Review
11.
Helsinki Declaration. World Medical Association Declaration of Helsinki. Available at: www.wma.net/e/policy/b3.htm (Last accessed 23 December 2006)
12.
KamanoMKoshimuneMToyamaMKazukiK. Palmar plating system for Colles’ fractures – a preliminary report. J Hand Surg Am. 2005, 30: 750–5.
13.
LeungKFWongWWTayMSChuMMNgSS. Development and validation of the interview version of the Hong Kong Chinese WHOQoL-BREF. Qual Life Res. 2005, 14: 1413–19.
14.
MahETAtkinsonRN. Percutaneous Kirschner wire stabilization following closed reduction of Colles’ fractures. J Hand Surg Am. 1992, 17: 55–62.
15.
MoherDSchulzKFAltmanD. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA. 2001, 285: 1987–91.
16.
MusgraveDSIdlerRS. Volar fixation of dorsally displaced distal radius fractures using the 2.4-mm locking compression plates. J Hand Surg Am. 2005, 30: 743–9.
17.
RingDJupiterJB. Percutaneous and limited open fixation of fractures of the distal radius. Clin Orthop Relat Res. 2000, 375: 105–15.
18.
Rodriguez-MerchanEC. Plaster cast versus percutaneous pin fixation for comminuted fractures of the distal radius in patients between 46 and 65 years of age. J Orthop Trauma. 1997, 11: 212–17.
19.
ShankarNSCraxfordAD. Comminuted Colles’ fracture: a prospective trial of management. J R Coll Surg Edinb. 1992, 32: 199–202.
20.
StoffelenDVBroosPL. Closed reduction versus Kapandji-pinning for extra-articular distal radius fractures. J Hand Surg Br. 1999, 24: 89–91.
21.
WillisAAKutsumiKZobitzMECooneyWP. Internal fixation of dorsally displaced fractures of the distal part of the radius. A biomechanical analysis of volar plate fracture stability. J Bone Joint Surg Am. 2006, 88: 2411–17.
