Percutaneous pinning of fractures of the distal radius

Reduction of fractures of the distal radius is often supplemented with percutaneous pinning, but there is little evidence that this affects the clinical outcome. A total of 43 patients with pinned, and 296 with conservatively-treated, fractures were reviewed a mean of 6 (range 3-13) years after injury. We found controls among the conservatively-treated patients who matched 30 of the patients with pinned fractures with respect to age, sex, trauma energy, and radiographic measurements at injury. Clinical and radiological results of the two groups were compared and contrasted. There was a trend for better radiological results in patients with pinned fractures, but not significantly so, and no difference in clinical variables. We identified seven published randomised studies in which pinning was compared with reduction and plaster of Paris alone. Most reported better radiological results at review. The three smallest studies with the shortest follow-up reported better clinical outcome for pinned fractures, while the remaining four studies found no significant clinical benefit from pinning. Although the radiological results were improved by percutaneous pinning in addition to reduction and plaster of Paris, the clinical outcome in extra-articular and simple intra-articular fractures seemed unaffected.