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Distal Radius Fracture Fixation Using a Specialized Threaded Pin
John S. Taras, MD; Jason Saillant, MD; Peter Goljan, MD
The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA

Introduction: This study presents the outcomes of extraarticular and simple intraarticular distal radius fractures stabilized with a specialized, threaded, cannulated device.?

Materials & Methods: This is a prospective study of distal radius fractures treated with a specialized pin for distal radius fracture fixation. A minimum of 1 year of postoperative follow-up was required for inclusion in the study. The outcome data included wrist range of motion, grip strength, and lateral pinch strength. Radiographs obtained at each visit were analyzed to determine volar tilt and radial height. At the final follow-up visit, all patients completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

Results: A total of 24 patients with 24 distal radius fractures were included in this study. At an average of 2 years after surgery (range, 1 to 6 years), flexion was 89%, extension 96%, supination 99%, and pronation 100% of contralateral wrist motion. Grip strength was 93% (range, 40% to 137%) and lateral pinch strength was 99% (range, 48% to 130%) of the contralateral upper extremity. Preoperative AO fracture classification disclosed 6 type A2, 12 type A3, 4 type C1, and 2 type C2 fractures. One patient who admitted noncompliance with functional restrictions lost radial height of 6 mm from initial postoperative- to final follow-up radiographs. The average final DASH score was 4.4 (range, 0 to 35). Hardware was removed electively in 1 case and because of tenderness with wrist range of motion in 1 case. After hardware removal, neither patient expressed further complaints. No other complications or secondary surgeries occurred.

Conclusions: Specialized pin fixation offers stable, reliable fracture fixation for the treatment of extraarticular and simple intraarticular distal radius fractures. The intramedullary placement of the device and its minimally invasive approach diminishes postoperative soft tissue complications. The stability of the fixation allows patients to begin active range of motion early in their postoperative course.

Figure 1 (left); Preoperative PA radiograph of a typical extraarticular fracture amenable to fixation with the specialized threaded pin; (right) postoperative PA radiograph of a common pin placement pattern in which 2 pins are placed through a single incision at the radial styloid.

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