Functional outcome of displaced distal radius fractures treated with the five K-wire fixation technique: a prospective observational study
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262916Keywords:
Distal radius fracture, Kirschner wire, Modified mayo wrist score, Percutaneous fixationAbstract
Background: Distal radius fractures are among the most frequently encountered fractures in orthopaedic practice and can result in significant impairment of wrist function if inadequately managed. Although several surgical techniques are available for unstable distal radius fractures, the optimal fixation method remains controversial. The five K-wire fixation technique is a minimally invasive, cost-effective method that aims to provide stable fracture fixation while preserving soft tissue integrity and fracture biology. The present study evaluated the functional outcome of displaced distal radius fractures treated using this technique.
Methods: A prospective observational study was conducted over one year among 30 adult patients with displaced intra-articular distal radius fractures managed with the five K-wire fixation technique. Fractures were classified according to the Frykman classification. Functional outcome was assessed using the Modified Mayo Wrist Score (MMWS) at 6 weeks, 3 months and 6 months. Fracture union, wrist range of motion and postoperative complications were also evaluated. Statistical analysis was performed using SPSS version 26.0 and a p value <0.05 was considered statistically significant.
Results: The mean age of the participants was 44.13±14.22 years and 56.7% were male. Fall on an outstretched hand was the most common mechanism of injury (53.3%). Fracture union was achieved within 6–8 weeks in 86.7% of patients. The mean modified mayo wrist score improved significantly from 65.50±7.97 at 6 weeks to 76.60±8.77 at 3 months and 85.03±8.87 at 6 months (p<0.001). At final follow-up, 46.7% of patients had excellent functional outcomes, 36.7% had good outcomes and 16.7% had fair outcomes. Pin tract infection was the most frequent complication, occurring in 10% of patients.
Conclusions: The five K-wire fixation technique provides satisfactory fracture union, significant functional improvement, acceptable wrist mobility and a low complication rate. It represents a safe, minimally invasive and economical treatment option for displaced distal radius fractures, particularly in resource-constrained healthcare settings.
References
Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691-7.
Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin. 2012;28(2):113-25.
Chung KC, Shauver MJ, Birkmeyer JD. Trends in the United States in the treatment of distal radial fractures in the elderly. J Bone Joint Surg Am. 2009;91(8):1868-73.
Jupiter JB. Fractures of the distal end of the radius. J Bone Joint Surg Am. 1991;73(3):461-9.
Knirk JL, Jupiter JB. Intra-articular fractures of the distal end of the radius in young adults. J Bone Joint Surg Am. 1986;68(5):647-59.
Mackenney PJ, McQueen MM, Elton R. Prediction of instability in distal radial fractures. J Bone Joint Surg Am. 2006;88(9):1944-51.
Handoll HHG, Madhok R. Surgical interventions for treating distal radial fractures in adults. Cochrane Database Syst Rev. 2009;3:3209.
Lichtman DM, Bindra RR, Boyer MI, Putnam MD, Ring D, Slutsky DJ, et al. Treatment of distal radius fractures. J Am Acad Orthop Surg. 2010;18(3):180-9.
Orbay JL. The treatment of unstable distal radius fractures with volar fixation. Hand Surg. 2000;5(2):103-12.
Margaliot Z, Haase SC, Kotsis SV, Kim HM, Chung KC. A meta-analysis of outcomes of external fixation versus plate osteosynthesis for unstable distal radius fractures. J Hand Surg Am. 2005;30(6):1185-99.
Kapandji A. Internal fixation by double intrafocal pinning: functional treatment of non-articular fractures of the lower end of the radius. Ann Chir Main. 1987;6(1):57-63.
Rayhack JM. The history and evolution of percutaneous pinning of displaced distal radius fractures. Orthop Clin North Am. 1993;24(2):287-300.
Fernandez DL, Jupiter JB. Historical perspective. In: Fernandez DL, Jupiter JB, editors. Fractures of the Distal Radius: A Practical Approach to Management. New York (NY): Springer; 2002: p. 1-12.
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