Transulnar percutaneous pinning of displaced distal radial fractures: a preliminary report

Difficulty in maintaining the reduction of displaced radial fractures has prompted the use of numerous techniques to address this problem. The purpose of this study was to determine if four or five 0.045-in Kirschner pins when placed percutaneously through the ulna into the radius could maintain the reduction of this unstable fracture configuration. A 15-month average follow-up of 14 patients, averaging 48 years old, included subjective patient responses and range-of-motion measurements of the forearm, wrist, and digits in addition to grip strength determinations. Analyses of the radial angle and radial height were made on the posteroanterior radiograph, and the articular inclination was assessed on the lateral radiograph. Overall results were 2 excellent and 12 good using the Scheck demerit system of evaluation. The advantages of this technique are as follows: Radial sensory nerves are avoided; use of a lightweight splint at 3 weeks promotes patient comfort and facilitates finger range-of motion exercises; percutaneous pins are easily removed in the office without anesthesia; and pin site scars are barely perceptible at follow-up in the majority of patients.