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  • Title: Long-term outcomes of closed reduction and percutaneous pinning for the treatment of distal radius fractures.
    Author: Glickel SZ, Catalano LW, Raia FJ, Barron OA, Grabow R, Chia B.
    Journal: J Hand Surg Am; 2008 Dec; 33(10):1700-5. PubMed ID: 19084166.
    Abstract:
    PURPOSE: The purpose of this study was to review the long-term outcomes of patients with distal radius fractures treated with closed reduction and percutaneous pinning. METHODS: We retrospectively reviewed 54 patients with 55 AO type A2, A3, C1, or C2 distal radius fractures treated with closed reduction and percutaneous pinning. The average age of the patients was 57 years. All patients returned for follow-up examination at an average of 59 months, with a minimum of 22 months. Measurements included active range of motion, grip strength, pain assessment, Disabilities of the Arm, Shoulder, and Hand scores, and final radiographic assessment. The paired t-test was used to determine significant differences. RESULTS: All fractures healed within 6 weeks. Active range of motion and grip strength of the injured wrist were statistically equal to those of the uninjured wrist for each of the parameters except wrist flexion and forearm supination. However, the difference in wrist flexion was 5 degrees and the difference in supination was 4 degrees , both of which are of little clinical importance. Eighty-five percent of patients were pain free. Radiographic parameters comparing the immediate postoperative view with the views taken at final follow-up showed no significant differences. One patient required reoperation for loss of reduction after a fall in the preoperative period, and 3 others had minor complications. CONCLUSIONS: Patients treated with closed reduction and percutaneous pinning for distal radius fractures had excellent range of motion, normal Disabilities of the Arm, Shoulder, and Hand scores, and no significant differences in the radiographic parameters between fracture fixation and fracture healing. Complications were few. Pinning is an efficacious, low-cost treatment option for 2- and 3-part distal radius fractures with excellent long-term results. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
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