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[Reduction and osteosynthesis with pin fixation of wrist fractures. A comparative study between Kapandji's and Py's
O Delattre1, G Saillant, J Lemoine
1Service de chirurgie orthopédique, Hôpital de la Pitié-Salpêtrière, Paris.
Material:
62 fractures of the distal radius were treated by pin fixation: Kapandji's intra focal pinning in 28 cases (Group "K") and Py's elastic pinning in 34 cases (group "P"). The two groups were comparable as to the type of fractures (Castaing classification). Theoretical principles were analyzed and compared.
Results:
Final radiographic results showed the same proportion (75 per cent) of anatomic reduction in both groups. There were 21.4 per cent (6/28) hyporeductions in group K, and 23.5 per cent (8/34) hypereducations in group P. Hyporeduction was moderate with good functional results. Hypereduction in group P was often associated with bad functional results, 5 out of the 6 bad results of all the cases. The functional result, with a follow up of 7 months (4 to 10), was 76 per cent of excellent and good results, 85 per cent in group K, 70 per cent in group P.
Discussion:
Kapandji's technique seemed more reliable than Py's technique. We propose a technical variation to minimize hyporeduction in Kapandji's technic: increasing the pin's angulation.
Conclusion:
Py's technic conserves one indication: intra operative failure of Kapandji's technique in very osteoporotic bone.