K-wire fixation for redislocated Colles' fractures. Malunion in 8/21 cases

Area of Science:

• Orthopedic surgery
• Traumatology

Background:

• Colles' fractures are common wrist injuries.
• Redislocation can occur after initial treatment.
• Closed reduction and transstyloid Kirschner-wire fixation is one management option.

Purpose of the Study:

• To evaluate the outcomes of closed reduction and transstyloid Kirschner-wire fixation for redislocated Colles' fractures.
• To identify factors contributing to malunion and poor functional results.

Main Methods:

• Retrospective review of 21 patients with redislocated Colles' fractures treated with closed reduction and transstyloid Kirschner-wire fixation.
• Fracture classification using Older's system.
• Functional outcome assessment using the Gartland and Werley point system.
• Median follow-up of 2 years.

Main Results:

• 11 patients experienced loss of radial tilt and radial length.
• 8 wrists developed malunion, attributed to fracture comminution or inadequate Kirschner-wire fixation.
• Functional outcomes were rated as poor in 2, fair in 11, good in 4, and excellent in 4 wrists.
• No significant difference in secondary displacement or functional outcome between Older's type 3 and type 4 fractures.

Conclusions:

• Transstyloid Kirschner-wire fixation is often insufficient for stabilizing redislocated distal radial fractures.
• External fixation may be a superior alternative for achieving stability and preventing malunion.