Functional and Radiological Outcome of Unstable Distal End Radius Fractures After Management With Closed Reduction and Fixation With Percutaneous Pinning Versus Closed Reduction and Colles' Cast Application: A Comparative Study.

BACKGROUND

Distal end radius fractures are a common orthopaedic presentation and among the most frequent fractures in adults. Management options include closed reduction with Colles' cast immobilisation (CRCI) and closed reduction with percutaneous pinning (CRPP). This study aimed to evaluate and compare the functional and radiological outcomes of two treatment modalities for unstable distal radius fractures.

METHODS

A prospective comparative study was conducted in the Department of Orthopaedics of Dr. Baba Saheb Ambedkar Medical College and Hospital, a tertiary care centre in New Delhi, India, spanning 18 months from July 2022 to July 2025. This study was conducted on 80 patients with unstable distal end radius fractures, allocated alternately into two groups: CRCI and CRPP. Patients were assessed clinically and radiologically at regular intervals. Functional evaluation was carried out using the Mayo Wrist Score, Modified Gartland and Werley Score, and Green and O'Brien Scoring System. Radiographic assessment followed Sarmiento's modification of Lindstrom's criteria. Data analysis was performed using IBM SPSS Statistics for Windows, Version 20 (IBM Corp., Armonk, NY, USA), with a p-value of <0.05 considered statistically significant.

RESULTS

The CRPP group showed significantly better radiological parameters, including radial length, inclination, and volar tilt, compared to the CRCI group (p < 0.05). The CRPP group demonstrated better functional outcomes, with significantly higher Mayo Wrist, Modified Gartland and Werley, and Green and O'Brien Scores. Moreover, forearm rotation (supination and pronation) and wrist motion (radial and ulnar deviation) were markedly improved in the CRPP group.

CONCLUSIONS

CRPP demonstrated superior functional and radiological outcomes compared to Colles' cast immobilisation for unstable distal end radius fractures. This technique allows more precise fracture reduction under fluoroscopic guidance and is recommended as the preferred option in suitable patients.