Evaluation of role of subchondral ulno¬-radial k wire to avert collapse in non-comminuted extra and intra-articular fracture of distal end radius

Background: A prospective study was done in the Department of Orthopedics in D.Y Hospital, Navi Mumbai from October 2015 to February 2017 to evaluate role of subchondral ulno-radial k wire to avert collapse in non-comminuted extra and intra-articular fracture of distal end radius. Methods: All the patients attending OPD and emergency with non-comminuted distal end radius fracture without ulna fracture were admitted and operated in our hospital over a period of 1 year and 6 months. A total of 30 patients were included in our study and fixed with percutaneous k-wires (Bicortical cross) along with a transverse trans ulno-radial k wire directed from distal ulnar metaphysis to distal radius subchondrally, so as to fix DRUJ & maintain ulnar variance and radial height by preventing its immediate as well as late collapse. AO classification for fractures was used and only type A (extra-articular A1& A2), type C (Complete articular C1) were included. Type B (partial articular) was excluded from study. Results: All the 30 subjects (n=30) of fracture distal end radius, were managed by closed reduction and percutaneously fixed bicortical k-wires along with subchondrally placed distal trans ulno-radial k wire. Anatomical evaluation was done according to the Sarmiento’s modification of Lindstrom Criteria. Clinical and functional outcomes were evaluated according to the demerit point system of Gartland and Werley with Sarmiento modification. Conclusion: To accomplish anatomical reduction with DRUJ congruence and neutral to negative ulnar variance along with maintenance of radial height in extra articuar and intra articlar distal radius fracture only k wire fixation is not competent enough and needs augmentation with trans ulnoradial k wire. Trans ulno-radial k wire provides addon to rigid fixation and helps in prevention of early and late collapse thus ensuring better anatomical, functional and radiological outcome. Keywords: Distal radius, Percutaneous Fixation, Transulno radia