Percutaneous pinning for distal radial fractures in adults

Across-fracture percutaneous pinning may provide some anatomical and functional advantages as compared to plaster cast immobilisation in the treatment of fractures of the distal radius in adults. In general, the precise role and methods of percutaneous pinning are not established. Biodegradable pins and Kapandji fixation seem to be associated with an excess of complications.

A Cochrane review included 13 studies with a total of 940 subjects, generally older adults with dorsally displaced and potentially or evidently unstable distal radial fractures. Across-fracture percutaneous pinning (5 trials) was associated with improved anatomical outcome and generally minor complications as compared with plaster cast immobilisation. There was some indication of similar or improved function in the pinning group. Biodegradable pins were associated with a significant excess of complications as compared with metal pins (2 trials). Kapandji fixation was associated with a higher incidence of complications as compared with other pinning methods or plaster cast immobilisation.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by inconsistency (heterogeneity in interventions and outcomes).

Ədəbiyyat

1. Handoll HH, Vaghela MV, Madhok R. Percutaneous pinning for treating distal radial fractures in adults. Cochrane Database Syst Rev 2007 Jul 18;(3):CD006080.