External pin fixation for unstable Colles' fractures

Area of Science:

• Orthopedic surgery
• Traumatology
• Biomedical engineering

Background:

• Unstable Colles fractures pose significant challenges in achieving optimal bone alignment and wrist function.
• Traditional treatment methods may result in complications such as malunion, nonunion, and loss of range of motion.

Purpose of the Study:

• To evaluate the efficacy and outcomes of using a double-pin Roger Anderson apparatus for treating unstable Colles fractures.
• To assess key functional parameters including wrist range of motion, deformity, pain, and grip strength post-treatment.

Main Methods:

• A prospective study involving 130 patients with unstable Colles fractures treated with a double-pin Roger Anderson apparatus.
• Pins were inserted perpendicularly into the second and third metacarpals and the distal radius.
• Sixty patients were followed for two years to assess radiographic and functional outcomes.

Main Results:

• Median shortening was 2 mm, and median dorsal angulation was 3 degrees.
• Average wrist dorsiflexion was 58 degrees, volar flexion 50 degrees, with a 5-degree loss in pronation/supination.
• 85% of patients reported good or excellent subjective results, while objective analysis (McBride system) showed 90% good to excellent outcomes.
• 92% reported no pain, 89% no deformity, and mean grip strength was 20 kg.
• Only 3 patients required repeat reduction; 7 out of 16 complications involved pin loosening, typically late and without adverse sequelae.

Conclusions:

• The double-pin Roger Anderson apparatus is an effective treatment for unstable Colles fractures, yielding favorable functional and radiographic results.
• The technique demonstrates a low rate of revision surgery and acceptable complication profile, with pin loosening being the most common issue.
• High patient satisfaction and good functional recovery, including minimal pain and deformity, support the use of this fixation method.