The Amount and Related Factors of Reduction Loss in Distal Radius Fracture after Treatment by Kapandji Technique

Eun-Sun Moon; Myung-Sun Kim; Il-Kyu Kong

doi:10.12671/jkfs.2007.20.3.252

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Moon, Kim, and Kong: The Amount and Related Factors of Reduction Loss in Distal Radius Fracture after Treatment by Kapandji Technique

Original Article

Journal of the Korean Fracture Society 2007; 20(3): 252-259.

Published online: 14 June 2016

DOI: https://doi.org/10.12671/jkfs.2007.20.3.252

The Amount and Related Factors of Reduction Loss in Distal Radius Fracture after Treatment by Kapandji Technique

Eun-Sun Moon, M.D., Myung-Sun Kim, M.D., Il-Kyu Kong, M.D.

Department of Orthopaedic Surgery, College of Medicine, Chonnam National University, Gwangju, Korea.

Address reprint requests to: Myung-Sun Kim, M.D. Department of Orthopaedic Surgery, Chonnam National University College of Medicine, 8, Hak-dong, Dong-gu, Gwangju 501-757, Korea. Tel: 82-62-220-6336, Fax: 82-62-225-7794, rhamses@chol.com

Abstract

Purpose

To evaluate the amount and related factors of reduction loss in distal radius fracture after treatment by Kapandji technique.

Materials and Methods

From September 2004 to May 2006, 44 cases (43 patients) of distal radius fractures were treated by Kapandji technique. Fracture were classified with AO classification and volar tilt, radial inclination, and radial length were measured in preoperative, immediate, postoperative radiographs. Also the amount and related risk factors of reduction loss were analyzed. In addition, the radiological results at last follow up were evaluated using modified Lidstrom scoring system.

Results

There was significantly more reduction loss of volar tilt in the patients with AO type C comparing with other fracture types, but the patients who were treated using three k-wire fixations including intrafocal K-wires showed significantly more reduction loss of volar tilt also. Overall radiological results at last follow up showed that excellent was 50% in cases with dorsal comminution, but, the other cases 90%. In addition, excellent was 70% in type A cases, but, in type C 44%.

Conclusion

Kapandji technique percutaneous pinning is the one of effective treatment options for distal radius fracture. But, type of fracture, total number of K-wires, and presence of dorsal cortical comminution showed the significant relation with postoperative reduction loss of volar tilt and overall radiological results at last follow up.

Keywords: Distal radius fracture, Kapandji technique, Reduction loss

Figures and Tables

Fig. 1

Intrafocal pin technique of Kapandji. The two K-wires are inserted into the fracture site rather than through the distal fracture fragment both radially and dorsally. The K-wires are then levered up to reduce the fracture and advanced through the opposite proximal intact far cortex to prevent redisplacement of the distal fragments. These intrafocal pinnings of K-wires buttress the distal fragments and allow the maintenance of radial inclination and palmar tilt, respectively.

Fig. 2

22-year-old man of extraarticular distal radius fracture without dorsal comminution was treated by Kapandji technique percutaneous pinning.

(A) Preoperative radiographs show AO classification A2 fracture.

(B) Immediate postoperative radiographs show that radial length, volar tilt and radial inclination are well restored.

(C, D, E) Radiographs at postoperative 1, 2, 4 weeks show the maintenance of reduction well.

(F) Radiographs at last follow up show excellent radiological result without significant reduction loss.

Fig. 3

55-year-old woman of intraarticular distal radius fracture with dorsal comminution was treated by Kapandji technique percutaneous pinning.

(A) Preoperative radiographs show AO classification C2 fracture.

(B) Immediate postoperative radiographs show that radial length, volar tilt and radial inclination are relatively well restored.

(C, D, E) But, radiographs at postoperative 1, 2, 4 weeks show the progressive development of reduction loss in all radiological

parameters.

(F) Radiographs at last follow up show fair radiological result with significant reduction loss.

Table 1

The overall amount of reduction loss according to various radiographic parameters at each postoperative period

S.D.^*: Standard deviation, ^†Immed.: Immediate, ^‡POD: Postoperative day, ^§F/U: Follow up.

Table 2

Radiological results at last follow up according to assessment by criteria for anatomical result

Table 3

The total amount of reduction loss in three radiological parameters at last follow up according to various factors

^*Statistically significant value, ^†Period of postoperative immobilization using short arm splint.

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