Unstable distal radius fractures treated by modified Kirschner wire pinning: anatomic considerations, technique, and results.

A modified technique of percutaneous Kirschner-wire pinning for unstable distal radius fractures is presented. Three to four pins are placed from the radial styloid process toward and through the dorsal, volar, and ulnar cortices of the proximal fracture fragment, respectively. Rotational stability is achieved by bending and counterblowing of the wire ends in the styloid process. Anatomic studies of cadaver wrists revealed possible lesions of the superficial radial nerve, the cephalic vein, and the tendons of the brachioradialis muscle or the thumb and wrist extensors, respectively. Nevertheless, in a follow-up of 80 patients after 1 year, no tendinous lesions nor any other serious complications were seen. Using the criteria of Green and O'Brien, the results were excellent in 66.25%, good in 20%, and fair in 8.75%.