Closed Reduction and Percutaneous Kirschner Wire Fixation versus Open Reduction and Internal Fixation by Plate and Screws in Treatment Displaced Unstable Intra Articular Distal Radial Fractures

Fracture of distal radius comprises approximately one-sixth of all fractures. We managed 128 patients with closed dorsally displaced unstable intraarticular distal radial fractures (CDUIADRF), AO Type C, during the period between November 2011 and December 2016 (with a mean follow up of 18 months) at Al Sader Medical City Hospital (academic medical center) in Najaf, Iraq.

There were 64 cases treated by open reduction and internal fixation by volar locked plate and screws (ORIF) method and 64 treated by closed reduction and percutaneous Kirschner wires fixation (CRPKF) in 21–82 years old patients. The results were assessed clinically by Disabilities of the Arm, Shoulder and Hand scoring system (DASH) and radiologically by Lidström and Frykman classification. This classification is modified by Sarmiento, et al.

Regarding ORIF method, the outcome was excellent in 54%, good in 32%, and fair in 8% cases and poor in 6%, but with CRPKF method the outcome was excellent in 44%, good in 28%, fair in 14% and poor in 14%.

We concluded that the open reduction and internal fixation by plate and screws method are superior to the closed reduction and percutaneous Kirschner wires fixation method.