Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (9): 1680-1685.doi: 10.3969/j.issn.1673-8225.2011.09.039

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Minimally invasive Kirschner wire combined with external fixation for repair of unstable distal epiphyseal fracture of radius

Ren Yi1, Hu Jian-shan1, Li Pu1, Song Xi-lun1, Tang Guang-ying1, Cen Shi-qiang2, Chen Qi-kuan1, Cao Yang-bin1, Feng Lin3,Yu Xue-wen1   

  1. 1Department of Orthopaedics, Qiannan Traditional Chinese Medical Hospital (Third Affiliated Hospital of Guiyang College of Traditional Chinese Medicine), Duyun  558000, Guizhou Province, China
    2Department of Orthopaedics, West China Hospital of Sichuan University, Chengdu  610041, Sichuan Province, China
    3Department of Acupuncture, Guiyang College of Traditional Chinese Medicine, Guiyang  550000, Guizhou Province, China
  • Received:2010-11-25 Revised:2011-01-17 Online:2011-02-26 Published:2011-02-26
  • About author:Ren Yi, Attending physician, Department of Orthopaedics, Qiannan Traditional Chinese Medical Hospital (Third Affiliated Hospital of Guiyang College of Traditional Chinese Medicine), Duyun 558000, Guizhou Province, China renyi3939@yahoo.cn
  • Supported by:

    the Key Item for Traumatology Construction of State Administration of Traditional Chinese Medicine of China during the “Eleventh-five-year Plan”, No. 24JZX1L116K110*

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Abstract:

BACKGROUND: Postoperative complications, such as radial shortening and displacement of fractures, still exist in the clinical practice of treatment of distal radius fracture with only Kirschner wire or external fixation, especially in the treatment of unstable epiphyseal fracture. Kirschner wire is mainly indicated in distal radius fracture and it is rarely applied on the treatment of epiphyseal fracture.
OBJECTIVE: To explore the clinical curative effects of the minimally invasive treatment of unstable distal epiphyseal fracture of radius with the combination of external fixation and reduction and percutaneous Kirschner wire fixation.
METHODS: Implement surgical treatment on 90 children having distal epiphyseal fractures of radius with no cut by minimally invasive closure and reduction of epiphyseal fractures. Two treatment methods were used: in control group, external fixation of only across carpal joint, external fixation of across carpal joint and percutaneous Kirschner wire fixation were used in the observation group. All cases were followed up at 9 weeks and 24 months after fixation. The long-dated clinical curative effects after surgical operation, functional recovery and the change of X-ray films were compared.
RESULTS AND CONCLUSION: According to Cooney rating criteria, the good to excellent rate of the control group was 77%. According to X-ray evaluation, the good to excellent rate was 63.33%. The good to excellent rate of the observation group was 93% and 90 % according to Cooney rating criteria and X-ray evaluation. The difference was significant between two groups (P < 0.01). All the cases got the clinical healing of bones and recovery of wrist joint function. Studies show that: In the minimally invasive surgical treatment of unstable distal epiphyseal fracture of radius with the combination of external fixation and reduction and percutaneous Kirschner wire fixation, K-wire helps the reduction with appropriate palmar inclination and ulnar deviation. Cured by external fixation, static fixation of fractures with the help of K-wire and dynamic transarticular fixation, the patients have a simple postoperative treatment with reliable fixation, good shape, fair recovery of function and few complications of epiphysis malunion. The basic learning function returns to normal after surgical treatment and the curative effects are stable and satisfactory.

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