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Variables affecting stability of distal radial fractures fixed with K wires: A radiological study

Variables affectant la stabilité des fractures distales du radius embrochées

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Abstract

The aim of this retrospective study was to identify the variables associated with poor radiological outcome in distal radial fractures stabilized with K wires. Patients who underwent K-wire fixation for unstable fractures of the distal radius in the last 3 years were included. Fractures were classified according to AO classification. Immediate postfixation radiographs and radiographs taken just prior to removal of K wires were analyzed to study three radiological parameters: palmar or dorsal tilt, radial inclination, and ulnar variance. Changes in these parameters were used to grade the anatomical end result as excellent, good, fair, or poor according to the Stewart classification. The results were analyzed statistically against variables such as age, gender, AO classification, associated ulnar fracture, number of K wires used, delay in fixation, and duration of fixation. A total of 113 fractures were analyzed. Average age of patients was 56.2 years, with male-to-female ratio of 1:2. Average loss of radial tilt was 4.12°, loss of palmar tilt was 8.07°, and loss of ulnar variance was 3.12 mm. We found excellent results in 23.9%, good result in 56.6%, fair results in 15%, and poor results in 4.4% of patients. Age more than 65 years (P value 0.004), significant comminution (A3 or C3 in AO classification) (P value 0.007), and associated ulnar fracture (P value 0.015) were the variables found to have statistically significant correlation with poor radiological outcome.

Résumé

Le but de cette étude était d’identifier les variables liées aux pauvres résultats radiologiques dans les fractures distales du radius stabilisées avec des broches de Kirschner (K). Des patients ayant bénéficié de cette technique pour des fractures distales instables du radius durant les trois dernières années ont été inclus dans cette étude rétrospective. Les fractures ont été classifiées selon la classification AO. Des radiographies post-opératoires précoces et des radiographies prises juste avant l’ablation des broches de K ont été analysées pour étudier trois paramètres radiologiques (inclinaison palmaire ou inclinaison dorsale, inclinaison radiale et décalage ulnaire). Les changements de ces paramètres ont été employés pour évaluer le résultat final anatomique comme excellent, bon, moyen ou mauvais selon la classification de Stewart. Les résultats ont été analysés statistiquement pour des variables comme l’âge, le sexe, la classification AO, la fracture ulnaire associée, le nombre de broches de K utilisées, le délai de consolidation et la durée de la fixation. Un total de 113 fractures a été analysé. L’âge moyen des patients était de 56.2 ans avec un ratio hommes/femmes de 1:2. La perte moyenne d’inclinaison radiale était de 4.12 degrés, la perte d’inclinaison palmaire était de 8.07 degrés et la perte de décalage ulnaire était de 3.12 millimètres. Nous avons trouvé d’excellents résultats dans 23.9%, des bons résultats dans 56.6%, des résultats moyens dans 15% et des résultats mauvais dans 4.4% de patients. Un âge supérieur à 65 ans (valeur 0.004 de P), un comminution significative [A3 ou C3 dans classification AO ] (valeur 0.007 de P) et une fracture ulnaire associée (valeur 0.015 de P) étaient les variables avérées pour avoir statistiquement la corrélation significative avec de mauvais résultats radiologiques.

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Correspondence to Harish V. Kurup.

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The authors declare that this study complies with the current laws in the UK.

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Kurup, H.V., Mandalia, V., Singh, B. et al. Variables affecting stability of distal radial fractures fixed with K wires: A radiological study. Eur J Orthop Surg Traumatol 15, 135–139 (2005). https://doi.org/10.1007/s00590-005-0231-0

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