Bicortical K-wires for distal radius fracture fixation: how many?

The aim of this study was to find out whether number and position of K-wires influence the stability of distal radius fractures treated by percutaneous wire fixation. Patients who underwent K-wire fixation for unstable fractures of the distal radius over a period of three years were included in this retrospective study. Radiographs taken immediately after the procedure and radiographs taken after removal of K-wires were analysed to study three radiological parameters: palmar or dorsal tilt, radial inclination and ulnar variance. Loss of these angles was analysed statistically against the number of wires (2 or 3) and position of wires (from radial styloid or a combination of styloid and dorsal wires). Ninety-five fractures were analysed with a mean age of 52.8 years and male to female ratio of 1:2. Average loss of radial inclination was 5.2 degrees, loss of palmar tilt was 8.3 degrees and loss of ulnar variance was 3.4 mm. Using 3 wires or using a dorsal wire in addition to the styloid wires both improved the final radial length by 1.2 mm and 2 mm respectively, but the effects were statistically not significant. We found that the number or position of wires did not influence radiological outcome. Based on our findings we recommend the use of two K-wires: one from the radial styloid and one from the dorsal side for these fractures.