Distal end radius fracture account for about 16-18% of all upper limb injuries. Various methods of closed reduction coupled with additional fixation methods have been claimed to give better results. One of these methods is Kapandji's intrafocal pinning technique. We decided to carry out this study for comparison of traditional cast immobilization versus closed reduction with Kapandji intrafocal pinning technique
Material and methods: A randomized prospective comparative study was carried out in orthopaedic department from 2011 July to 2016 June. 30 patients were subjected to closed reduction and cast and 30 were subjected to closed reduction and intrafocal pinning technique. Intrafocal pinning technique under C Arm guidance and GA, closed reduction was achieved wherever possible. If inadequate reduction was obtained, even then intrafocal wiring technique can be used for obtaining reduction also. 2 wire technique is commonly used. They were followed up at 1,2,4,6 and 12 weeks, radiologically and clinically.
Results: In the cast group, mean age in years was 62.16 and in the intrafocal pinning group mean age in years was 63.43 years (P=0.6097). Finger stiffness in 4 cases (13%) in cast group and 2 cases(7%) in pinning group. Sudeck's dystrophy was seen in 4(13%) cases in cast group and 3(10%) cases in pinning group. Pin tract infection was seen in 4(13%) patients in pinning group. Mean loss of radial length in cast group was 6.83mm and Intrafocal pinning group was 3.8mm (P value was <0.0003). In our study, we got significant difference in range of motion, VAS scores, loss of radial length, Saito chart, Lindstrom's criteria results of both groups.
Conclusion: Intrafocal pinning technique of Kapandji is superior modality of treatment for fracture distal end radius which are minimally comminuted, without intra-articular extension and grossly unstable as compared to closed reduction and casting technique.