Results of the Kapandji Procedure in the AO Type C Distal Radius Fracture in Patients over Age 60

Chul Hong Kim; Sung Soo Kim; Myung Jin Lee; Hyeon Jun Kim; Bo Kun Kim; Young Hoon Lim

doi:10.12671/jkfs.2012.25.3.191

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Kim, Kim, Lee, Kim, Kim, and Lim: Results of the Kapandji Procedure in the AO Type C Distal Radius Fracture in Patients over Age 60

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(3): 191-196.

Published online: 16 July 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.3.191

Results of the Kapandji Procedure in the AO Type C Distal Radius Fracture in Patients over Age 60

Chul Hong Kim, M.D., Sung Soo Kim, M.D., Myung Jin Lee, M.D., Hyeon Jun Kim, M.D., Bo Kun Kim, M.D., Young Hoon Lim, M.D.

Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea.

Address reprint requests to: Hyeon Jun Kim, M.D. Department of Orthopedic Surgery, Dong-A Medical Center, Dong-A University College of Medicine, 26, Daesingongwon-ro, Seo-gu, Busan 602-715, Korea. Tel: 82-51-240-5167, Fax: 82-51-254-6757, hyeonjun@dau.ac.kr

Received 29 July 2011 Revised 24 August 2011 Accepted 12 March 2012

Abstract

Purpose

To evaluate the clinical and radiologic results of the Kapandji procedure in AO classification type C distal radius fracture patients over 60 years old.

Materials and Methods

Twenty-one type C distal radius fracture patients over the age of 60 years who were treated with the Kapandji procedure from June 2004 to June 2009 in our hospital and had a post-operative follow-up period of more than 1 year were enrolled. The volar tilt, radial inclination, and radial length were measured for the radiographic analysis using the modified Lidstrom scoring system about post-operative reduction loss in every follow-up radiogram. The clinical result was assessed with a visual analogue scale (VAS) and Korean Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) score at the last follow-up.

Results

The mean radiologic loss of volar tilt was 1.1° and the mean loss of radial length was 2.6 mm and the mean radial inclination loss was 2.7° compared with the immediate post-operative period and last follow-up period. The average VAS and DASH scores were 1.4 and 15.9.

Conclusion

The radiologic results of closed reduction and percutaneous pinning using the Kapandji technique for distal radius AO type C fracture patients over 60 years of age was not satisfactory. Nevertheless, the clinical results were satisfactory.

Keywords: Wrist, Distal radius fracture, AO type C, Old age, Kapandji technique

Figures and Tables

Fig. 1

A 75-year-old female with unstable distal radius fracture was treated using a Kapandji technique.

(A, B) Pre-operative radiographs and computed tomography scan show AO classification type C1 distal radius fracture.

(C) Immediate postoperative radiographs show acceptable reduction and fixation.

(D) On last follow-up after removal of K-wires, radiographs show changes in the radiologic indices that reflect reduction loss (radial length, volar tilting and radial inclination are 3.0 mm, 4.3° and 1.9°, respectively).

Table 1

Radiological score

Table 2

Outcomes at last follow-up

VAS: Visual analogue scale. K-DASH: Korean Version of the Disabilities of the Arm, Shoulder and Hand Questionnaire. *Mean loss of each radiologic index between immediate post-operative period and last follow-up period.

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