K-wire fixation for redislocated Colles' fractures. Malunion in 8/21 cases

Abstract

One therapeutic alternative for redislocation of Colles' fractures is closed reduction and transstyloid Kirschner-wire fixation. We describe our results concerning 21 redislocations treated in this way. According to Older's classification, 8 fractures were type 3 and 13 fractures type 4. After a median followup period of 2 years, most patients had regained normal volar tilt, but significant loss of radial tilt and radial length was found in 11 patients. Malunion occurred in 8 wrists due to either fracture comminution or insufficient K-wire fixation. According to Gartland and Werley's point system, the end-results were poor in 2, fair in 11, good in 4, and excellent in 4 wrists. There was no statistically significant difference in secondary displacement and functional end-result between Older's type 3 and type 4 fractures. We conclude that K-wire fixation is frequently not firm enough and external fixation might be a better alternative for stabilizing redislocated distal radial fractures.