Radiographic outcomes of distal radius fractures treated by close reduction and external fixation with and without percutaneous pins

Background: External fixator is anappropriate device for the treatment of comminuted distal radius fractures, but there is no consensus about simultaneous supplementary percutaneous pinning. The present study was conducted to determine the short-term outcomes of comminuted distal radius fracture treated by close reduction and external fixation with and without supplementary pinning.

Methods: This prospective study was carried out on 62 patients with distal radius fracture type III. All consecutive patients were treated by close reduction and External Fixator (EXF) (N=30) and close reduction, External Fixator (EXF) with supplemental percutaneous pinning (N=32). Radiographic images of the wrist were takenbefore treatment and 1 week, 3 weeks and3 months after treatment.    

Results: There was no significant difference between the Dorsiflexion (DF)means of the wrist in the pin (43.5±9.2) and no-pin (41.3±6.9) groups (P=0.099). There was also a significant difference between the Palmar Flexion (PF) means of the wrist in the pin (50.8±8.6) and no-pin (48.3±10.6) groups (p=0.041).  Further, the means of wrist extension in the no-pin and pin groups were 16.3° and 17.2°, respectively, and for the wrist flexion in the no-pin and pin groups were 22° and 13.6°, respectively. The means of radial length difference in the pin and no-pin groups were 1.5 and 1.6 mm, respectively. Moreover, no significant difference was observed between radiographic indices of Radial Inclination (RI) and Volar Tilt (VT) in both groups.

Conclusions: Insertion of percutaneous pinning did not contribute to the improvement of comminuted distal radius fractures treated with external fixator.