مقايسه دو روش پين و پلاستر در بيماران با شكستگي ديستال راديوس

Pin and Plaster" for Distal Radius Fractures (A comparative study of two techniques)

Background: Distal radius fracture is a common injury, however, there is still controversy over the best treatment method of unstable fractures in this region. Using "pin and plaster" to treat such fractures, in spite of being an old technique, is still used by many surgeons. The results of such treatment at three University hospitals during a 2-year period is reported here. Methods: A prospective clinical trial was designed to compare the results of distal radius fracture using two different techniques of "pins and plaster" fixation. 54 patients in age range of 40 to 67 years who had sustained 57 distal radius fracture with low energy trauma were randomly divided into two groups: 29 fractures had proximal ulnar pin and 28 distal radius pins. Distal pins were inserted into metacarpals in both groups. Plaster incorporation of pins was used in all cases. The radiographic criteria of "radial inclination", volar tilt, ulnar variance and "gap" or "step" were used for evaluation on 3ʹʹd 8th, and 16th week X-ray. Results: Both techniques were similarly effective in obtaining and maintaining anatomic criteria of reduction. The rate of pin tract infection was similar in both groups, but the rate of pin loosening and nerve injury were significantly higher in patients treated with radial Schanz screws. Eight radial and 2 ulnar pins were loose at cast removal. Three sensory radial nerve parasthesias were temporary and improved with time. It is worth mentioning that this higher rate of complication did not affect the outcome because all of them were temporary. Conclusion: "Pin and plaster" is a feasible alternative in the treatment of low energy, unstable distal radius fractures and both techniques are equally effective in this regard.