TREATMENT OF DISPLACED FRACTURE OF DISTAL RADIUS BY INTRAMEDULLARY NAILING OF KIRSCHNER WIRES |
Poong-Taek Kim, Joo-Chul Ihn, Hyung-Soo Ahn, Joon-Ho Baek |
전위된 요골 원위단 골절에 대한 경피적 골수강내 K-강선 삽입에 의한 정복 고정법 |
김풍택, 인주철, 안형수, 백준호 |
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Abstract |
Purpose To analyze the effectiveness of intramedullary nailing of Kirschner wires for displaced distal radial fractures. Materials and Methods: From June 1998 to October 1999, twenty- three fractures of the distal radius in twenty patients were retrospectively evaluated for clinical and radiographic results following intramedullary nailing using Kirschner wires. Fractures with comminution greater than type C3 by AO classification or type 4 by Melone classification were not included. There were nine intraarticular fractures in this study. The treatment was followed by fixation in cast for four weeks with immediate finger motion, protected wrist motion with short arm splint for another four weeks, and then followed by free wrist motion. At eight weeks, Kirschner wires were removed under local anesthesia. The mean age was 53.8 years(range 19-75). The radiopraphic assessment included a scoring system based on measurements of the final dorsal angle, loss of radial length, and the radial inclination. The step-off of the radial articular surface was also evaluated for intraarticular fractures. Patients were monitored for the occurrence of skin irritation by pins, paresthesia of sensory branches of the radial nerve, loosening of pins, and injury of extensor tendons during the period of fixation by K-wires. Result: The final radiographic scores revealed that 5 cases(22%) had excellent, 17(74%) had good results and 1(4%) had a fair result. The increase in step-off of the articular surface in intraarticular fractures was small. Skin irritation by pins occurred 1 case(4%). Loosening of pins, nerve and tendon injury developed in none of the cases. Conclusion: Intramedullary nailing of K-wires is technically feasible, and maintaining good reduction. Irritation by pins and loosening of pins were rare. The most prominent feature of this technique is that it effectively prevents re-displacement of intraarticular fractures. |
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