Percutaneous cannulated screw fixation in the treatment of distal radius fractures.

PURPOSE: The aim of this study was to determine the results of closed reduction and percutaneous fixation of distal radial fractures with standard 4.0-mm cannulated screw.

METHODS

We collected prospective outcomes data for 20 patients between 18 and 60 years of age (mean 39) with acute, displaced, extraarticular and unstable fractures of the distal radius treated with closed reduction, percutaneous cannulated screw fixation and early mobilization. The visits at months 2, 6 and 12 were specified as index follow-up visits and assessments of motion, grip strength and standard radiographs were performed. The Gartland Werley functional scores and the Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores were recorded.

RESULTS

Mean values of flexion, extension, pronation and supination on the injured side were up to 70 % of those on the uninjured side at 2 months postoperatively. By 12 months, range of motion values on the injured side showed continuous and significant improvement and flexion, extension, pronation, supination and ulnar deviation reached up to 90 % of those on the uninjured side. A large and significant improvement was seen from 2 to 6 months in the QuickDASH score. A smaller improvement was seen from 6 to 12 months, which was judged not to be significant. Radiographic values were close to anatomic parameters, and the alignment was maintained at 12 months follow-up. No complications occurred.

CONCLUSIONS

Cannulated screw fixation appears to be an effective means of allowing immediate range of motion of the wrist, resulting in a rapid and comfortable functional recovery while maintaining alignment to bone healing.