K-WIRE FIXATION OF DISTAL RADIAL FRACTURE: WHAT IS THE BEST CONFIGURATION?

To ascertain the optimum number, thickness and configuration of K-wires needed to prevent displacement of distal radial fractures. Synthetic and cadaver bones were used. A transverse osteotomy was performed 1. 5 cm proximal to the articular surface of the distal radius. Different numbers and configurations of 1. 1mm or 1. 6mm K-wires were used to hold the bone reduced. Dorsoradial and distraction forces were applied using a tensiometer. The endpoint was a displacement of 3mm at the osteotomy site. We demonstrated a statistically significant increase in the force required to displace the osteotomy site a) when using thicker wires and b) when using three crossed wires compared with two wires either crossed or parallel. When balancing ease of insertion with maximum stability, we would recommend two parallel 1. 6mm wires inserted through the radial styloid process, with 1 wire inserted from the dorsoulnar corner of the radius crossing at approximately 90 degrees. All wires should pass into the opposite cortex. This configuration resisted forces of over 300 Newtons and there was little benefit in using additional wires.