A Comparative Study on Functional Outcome of Distal Radius Fractures Treated with POP Cast Versus Percutaneous K-Wire Fixation (Both After Closed Reduction) In Kannur Medical College, Kerala, India

Abstract

BACKGROUND Closed reduction with plaster of Paris (POP) cast for extra-articular distal radius fractures was an accepted method of treatment worldwide. But the maintenance of reduced fracture fragments was unpredictable. Closed reduction and ‘K’ wire fixation with casting was also recommended widely. There was no definite option prescribed for either of the methods. In this study, we wanted to compare the final outcome of management of the distal radius fractures in adults with closed reduction and POP casing versus closed reduction with percutaneous K-wiring. METHODS A prospective, randomized, and comparative study was conducted on the final outcome of two methods of treatment for the fractures of distal end of radius. One method (Group A of 23 patients) consisted of closed reduction and POP casing and the other (Group B of 23 patients) consisted of K-wiring under C arm (23 patients in each group). Radiological and functional parameters were compared at fixed intervals for 15 months and final outcome scores were correlated and compared using Gartland and Werley functional scoring system. RESULTS In group A, AO type 2R3A2.1 fractures were observed in 03/23 (13.04 %) patients and 04/23 (17.39 %) in Group B patients. Type 2R3A2. 2 fractures were observed in 05/23 (21.73%) of the group A patients and 07/23 of the group B patients. Type 2R3A2.3 fractures were observed in 15/23 of the group A and 12/23 (52.17%) of the group B patients. Both the methods of treatment were correlating well with the various variables. CONCLUSIONS Closed reduction with percutaneous K wiring and below elbow cast application was a simple, minimally invasive technique that provided added stability and functional outcome with respect to treatment of extra-articular distal radius fracture. The conventional method of closed reduction and POP cast was closely correlating with the K wire immobilization method. There was no significant statistical difference between the two methods in the functional outcome after treatment of distal end radius fractures. KEYWORDS Radius, ‘K’ Wire, Closed Reduction, Stable Fracture, Bone Healing and Immobilize