PURPOSE To analyze the results of surgical treatment of the displaced distal radius fractures in elderly patients over 65 years old who were treated with percutaneous K-wire fixation only and percutaneous K-wire fixation with external fixation.
MATERIAL AND METHOD: We evaluated 24 cases of the distal radius fracture in patients older than 65 years from January 1998 to December 2001. The patients were followed up at least 12 months postoperatively. We compared the surgical results of 14 cases, treated with percutaneous K-wire fixation only with the surgical results of 10 cases, treated with percutaneous K-wire fixation with external fixation. We evaluated the functional results according to demerit point system and the radiographic results (radial length, radial inclination, volar tilt). RESULTS According to demerit point system, the mean score of demerit point was 9.9 in the group of percutaneous K-wire fixation and 5.3 in the group of percutaneous K-wire with external fixation respectively (p<0.05). In radiographic results, the percent of the mean loss of radial length, radial inclination and volar tilt were 23.2%, 12% and 41.7% in the group of percutaneous K-wire fixation and 11%, 5.9% and 27.4% in the group of percutaneous K-wire with external fixation respectively (p<0.05). CONCLUSION Percutaneous K-wire with external fixation showed better functional and radiographic results than percutaneous K-wire fixation only for the treatment of the displaced distal radius fractures in elderly patients older than 65 years and percutaneous K-wire with external fixation is thought to be a one of the most effective treatment of the displaced distal radius fractures in elderly patients.
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Osteoporotic Distal Radius Fracture-conservative Treatment Seok-Whan Song Journal of the Korean Fracture Society.2008; 21(1): 81. CrossRef
PURPOSE To analyze children with displaced supracondylar fractures of the humerus that were treated by immediate closed reduction and then maintained by lateral percutaneous K-wire fixation. MATERIALS AND METHODS 70 cases of supracondylar fractures of the humerus(5 type I, 19 type II, 46 type III) were treated, 14 fractures(5 type I, 7 type II, 2 type III) with cast, 49 fractures(12 type II, 37 type III) with lateral percutaneous pinning, 7 fractures(7 type III) with open reduction and internal fixation. The K-wire were removed after averaging 6.2 weeks of operation in out patient clinic. The follow-up period ranged from 6 months to 28 months, averaging 13 months. RESULT By Flynn's functional and cosmetic criteria, 47 fractures(95.9%) among 49 fractures, treated with immediate closed reduction and lateral percutaneous pinning, resulted in satisfactory criteria. Only one fracture was reoperated due to reduction loss. CONCLUSION Immediate closed reduction and lateral percutaneous K-wire fixation appears to be safe and reliable option for the treatment of supracondylar fractures of the humerus in children.
PURPOSE To evaluate the clinical validity of the percutaneous K-wire fixation in applying to unstable extraarticular fracture of distal radius of patients who are older than 50 years.
MATERIAL AND METHODS: The validity of K-wire fixation was examined, using subjective study of Cole and Oblelz and objective study of Scheck, on the 20 cases of unstable extraarticular fracture of distal radius of patients older than 50 years, who were treated with percutaneous K-wire fixation and followed up more than 1 year, out of 160 patients with distal radius fracture, treated in the department of orthopedic surgery of our hospital from January 1994 to August 1998. RESULTS The result was examined with subjective study of Cole and Oblelz and objective study of Scheck. Combined judgement was made by adding up the scores of both objective and subjective study. 5 excellent cases and 12 good cases were brought forth by subjective study. Objective study achieved the result of average 18 degree of radial angle, 9.8mm of radial length and 3.6 degree of volar angle. Combined judgement achieved a good result of 3 excellent cases, 14 good cases and 3 fair cases. CONCLUSION Percutaneous K-wire fixation is expected to be a simple, less invasive, more effective and valuable operation method in the treatment of extraarticular fracture of distal radius with severe comminution
PURPOSE : To evaluate the role of the additional external fixator in maintenance of reduction with was known as an important prognostic factor for the treatment of intra-articular distal radius frctures.
MATERIAL AND METHOD : Thirty cases of unstalbe intra-articular fractures of the distal radius, which were treated by operative method, were classified by Frykman's method and grouped in two(group A and B). The group A was treated by closed reduction and percutaneous K-wire fixation and long arm cast immobilization. The group B was treated by treated by closed reduction and percutaneous K-wire fixation with use of additional external fixator. The end results were evaluated by the Demerit Point Rating System(by Sarmiento) & radiologic evaluation(radiologic index : radial length, radial tilt, volar tilt) RESULTS : By the Demerit point rating system, excellent and good results were rated by 45.5% in group A and 75% in group B and poor results were found in 3 cases which were Frykman type VII or VIII in group A. Radiologically, radial length loss was rated by 11%, radial tilt loss by 10.8% and volar tilt loss by 47% in group A and 3.1%, 6.8%, 29% each in group B(p<0.05). CONCLUSION : We think that additional use of external fixator, after percutaneous K-wire fixation, may have an important role in maintenance of reduction and group prognosis for the treament of intra-articular distal radius fractures.
The cases of 160 patients who had a displaced supracondylar fracture of the humerus were reviewed retrospectively. According to the Flynn's criteria, the results of treatment were excellent 33%, good 53%, fair 10%, poor 4%. No neurovascular complication was appeared. In two cases, cubitus varus deformity was appeared to be related with incorrect reduction. We believe that percutaneous k-wire fixation is excellent method in treatment of the displaced supracondylar fractures in children. There was no significant difference of clinical results among methods of percutaneous K-wire fixation but lateral 2 and medial 1 cross pinning has advantages : easy technique in insertion of lateral 2 pins, biomechanical stability and removal of medial pin in the irritation of ulna nerve without significant influence of stability.