Complex distal radius fractures treated by percuta-neous pinning. A prospective comparative study of cast immobilisation versus external fixator

Forty-six patients [37 women and 9 men] with unilateral comminuted intra-articular, unstable supination fractures of the distal radius were studied in a randomized prospective manner. The mean age was 62 years. They were treated by reduction under general anesthesia and percutaneous Kirschner wires fixation, followed by either plaster immobilization [group A] or Pennig external wrist fixator [group B]. The mean follow-up period was 21 months. Assessment protocol consisted of patient's questionnaire, medical record review and physical and radiographic evaluation. The demerit point system of Sarmiento was used to objectively evaluate the functional outcome. The results were good or excellent in 80.4%. Both methods maintained the reduction reasonably. Apart from early stiffness in the fixator group, no major differences were found between treatment groups. No late complications were found at the end of follow-up