Percutaneous pinning of distal radius fractures

Reduction of distal radius fractures is often difficult to maintain with plaster casting alone. Achieving this goal with an easily executed technique which carries a low morbidity is desirable, especially in multiply injured patients. Between July 1977 and September 1980, 24 high-energy fractures of the distal radius in 22 patients were treated by percutaneous pinning of the radial styloid fragment to the opposite radial cortex. Roentgenograms at the time of pinning and 8 weeks or more in followup demonstrating healing were available in 20 patients (22 fractures). Using a previously described method of roentgenographic grading, these cases were evaluated. At followup five fractures were felt to anatomically excellent, 16 good, and one poor. Five fractures in review were felt to be not ideally pinned and these represented three of the five fractures that lost a grade of evaluation rating during healing. One superficial pin tract infection developed and two patients complained of local pin discomfort. These complications resolved with pin removal. If guidelines for pinning are followed properly, percutaneous pinning provides a simple and useful method for maintaining reduction in unstable distal radius fractures in multiply injured patients.