Colles' Fracture; Is Kirschner Wire Fixation Sufficient Alone ?

From 01.07.2002 to 30.12.2003, 730 Colles' fracture were treated in orthopedics/trauma unit of Rashid Hospital, Dubai using different treatment modalities. Sixty of these fractures were treated as unstable cases and were managed by closed reduction, precutanous K.wire fixation and plaster immobilization. There were 7 females (11% mean age 38.14) and 53 males (88.3% mean age 37.32). Thirty of the fractures happened by falling from height, and 15 people from simple falling on outstretched hand when walking. Thirteen fractures resulted from road accidents. The fractures were studied and analyzed using Frykman's and Universal classifications. Two to 5 K.wires (mean 2.63)were used for precutanous fixation of the fractures. Reductions were checked by measuring the radial angle, volar angle, dorsal angle, dorsal displacement, radial displacement, axial shortening and articular incongruity. Postoperatively 34 reductions and K.wire fixations were found in unacceptable positions (56.7%). Analysis of the fractures in Frykman's classification showed a significant relation of Frykman's type 1 and 2 fractures with acceptable results (P= 0.037 and P= 0.028 respectively). Also type II Universal classification showed a significant relation to acceptable results (P= 0.003) but other types of Frykman's or universal classifications did not show meaningful results. Closed reduction and precutanous K-wire fixation remains an acceptable treatment for extra-articular Colles' fractures but this study could not validate its use for intra-articular Colles' fractures.