Long-Term Follow-up of Treatment of Comminuted Fractures of the Distal End of the Radius by Transfixation with Kirschner Wires and Cast

¹ SAN FRANCISCO, CALIFORNIA

1. Treatment of comminuted fractures of the distal end of the radius by transfixation with Kirschner wires and cast fixation is an effective method of maintaining reduction. An exacting method of assessment showed that the anatomical results were satisfactory in 75 per cent of the patients and unsatisfactory in 25 per cent. None of the latter group, however, showed a major deformity and none underwent subsequent surgery.

2. The functional results were good. All patients, but one, resumed their former occupations and recreational activities; five had some minor restrictions. There was an average loss of grip strength of 27 per cent in two-thirds of the patients. In keeping with common experience, the loss of grip strength was greater in compensation cases than in non-compensation cases.

3. As noted by previous observers, a poor anatomical result led to greater disability; four of the five fractures rated poor in the over-all evaluation also had a poor anatomical result. Healing with a negative volar angle, however, had no appreciable effect on the range of palmar flexion.

4. With application of a scale which considered all measurable factors, 79 per cent of the patients showed a satisfactory result and 21 per cent a poor result. From the patient's purely subjective view point, however, 96 per cent had a satisfactory result.

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