A Comparative Study Of The Functional Outcome Of k-wire Fixation With Cast Cersus Ligamentotaxis In Management Of Distal End Comminuted Fracture Radius

摘要

Introduction: Distal radius fractures are among the most common fractures of the upper extremity. In this study we compared the functional outcome of treatment of distal radius fractures with two different modalities, K-wire fixation with cast versus Ligamentotaxis. Materials and methods: Prospective study of Sixty five cases (40 males and 25 females) of intraarticular fractures of distal radius (Frykman types 3 to 8) treated by percutaneus K wire-cast or external fixator. Out of which 46 patients (25 male and 21 female) underwent K wire-cast and 19 patients (15 male and 4 female) underwent Ligamentotaxis with AO external fixator with supplementing pinning. Patients were evaluated clinically and functionally using Gartland and Werley Scoring system. Results: Mean age was 46.89 ± 14.75 years (range, 19 – 78 years) in K wire-cast group and 42.84 ± 15.60 years (range, 23 – 79 years) in Ligamentotaxis group. For the K wire-cast group the average Gartland and Werley score was 85.45 ± 8.14 (range, 60-100 points) and average grip strength as measured by hand dynamometer was mean 86.41 ± 8.73 % (range 60-100 %) of the normal hand. Average Gartland and Werley score for the Ligamentotaxis group was 83.03 ± 9.73 (range 50 – 97.5 points) with average grip strength of 83.16± 9.01 % (range 65-95 %). With an exception of reflex sympathetic dystrophy, which is an important predictor of poor outcome, most complications were minor and did not affect the end-result significantly. Discussion: There was no significant difference in results of K wire-cast and Ligamentotaxis, though the complication rates (pin tract infection) were slightly higher in external fixator group. Thus both methods work well for selected distal end radius fractures with acceptable clinical, functional results and low complication rates.