Modified Desmanet's intramedullary pinning for fractures of the distal radius

The purpose of this article is to present the results of Desmanet's intramedullary pinning for distal radius fractures, and also to present modifications of the cut-end management of pins; the cut-ends were shaped like a tear-drop for the radial pin and like a curtain-hook for the ulnar pin. One hundred and two operated patients (23 men and 79 women; mean age at operation, 61.0 +/- 17.5 years) were followed up for 9.6 +/- 12.9 months. The clinical results were satisfactory according to the demerit point system of Saito; 83 were assessed as excellent and 19, as good. On the X-ray measurements, the mean values for radial inclination angle, volar tilting angle, and ulnar variance were 23.5 degrees +/- 5.1 degrees, 8.8 degrees +/- 7.1 degrees, and 1.0 +/- 1.6 mm, respectively. Eighty-three patients (81.4%) showed no deformities. The results of 23 aged patients (older than 75 years) were also satisfactory, and this method thus appears to be a good choice for aged patients with osteoporosis. Modifications of the cut-ends of pins reduced the extensor tendon complications that occur with Desmanet's original method. The present method is also good for extra-articular Colles' fracture. Concerning intraarticular Colles' fractures, the undisplaced type and the ulnar split type are good indications for this method. This method can also be used for the dorsal split depression type, but the ulnodorsal split type is not a good indication.