Comparative study between percutaneous pinning and ligamentotaxis or both for the distal radius fracture

Introduction: Fractures of the distal radius which are stable i.e., extraarticular and not comminuted are different from fractures which are unstable i.e. intraarticular and comminuted. The final aim in the management of comminuted intraartciular fractures of distal radius is to restore normal function. The best method of obtaining and maintaining an accurate restoration of articular anatomy however remains a topic of considerable controversy. Methods: In our study 30 cases were treated by ligamentotaxis G1, percutaneous pinning G2 or both G3 were taken into consideration, 10 patients in each group; results were analyzed using Older et al criteria. Results: The least time of healing was seen in the combination of both group. In ligamentotaxis group 3 cases had excellent results (30%), in percutaneous pinning one case had excellent result (10%) and in the combination group 4 cases had excellent results (40%). In group1, 4 had good results (40%), in group 2, 4 had good results (40%) and in group 3, 4 had good results (40%). In ligamentotaxis group 3 had poor results (30%), in percutaneous pinning group 5 had poor results (50%) and in the combination group 2 had poor results (20%). The percutaneous pinning group showed the poorest results. Conclusion: In our study combined technique has shown satisfactory result that lead to high rate of return to work, high level of patient satisfaction and low rate of complications. Successful management of complex distal radial fractures necessitates careful assessment of fracture pattern, appropriate patient selection, a careful and meticulous surgical approach, appropriate choice of fixation device and pins, judicious use of Judgment with internal fixation and early rehabilitation.