Combined Kirschner wire fixation in the treatment of Colles fracture. A prospective, controlled trial.

For surgical treatment of the unstable Colles fracture we developed a new form of osteosynthesis, which consists in a modification of the dynamic Kirschner wire fixation described by Kapandji. It allows early motion without the typical risk of palmar dislocation noted with the Kapandji method. We prefer this method in elderly patients with reduced bone quality. The analysis of a collective of 110 fractures including a clinical and radiological follow-up examination of 72 patients revealed good anatomical reconstruction of the distal radius. The loss of motion was minimal on average and consistent with a good wrist function. Major restrictions resulted from stress-dependent pain as a consequence of posttraumatic arthritis or algodystrophy. A minor loss of reduction by dorsal impaction was observed in the follow-up evaluation, but it had no functional relevance. The most frequent complication was paraesthesia within the area of the superficial radial nerve. According to the NYOH score the following results were achieved: excellent 35%, good 50%, fair 10%, poor 5%.