Locked versus Nonlocked Percutaneous K-wire Fixation in Distal Radius Fractures Treatment: a Comparative Study for Maintenance of Postoperative Alignment

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Thisayapong Inta-ngam


Background: Distal radius fractures (DRF) are typically treated with percutaneous K-wire fixation and a short-arm slab. Linking all K-wires that were fixed to a fracture site in one system (locked K-wire system) could withstand an immediate physiologic load more than the non-locking system. Whether this system could maintain the fracture alignment until union without immobilization is questionable.
Objectives: To compare the maintenance of radiographic wrist parameters in percutaneous K-wire fixation for closed extra-articular and simple partial intraarticular DRF between locked and nonlocked K-wire systems.
Material and methods: A prospective non-randomized controlled trial was conducted in patients with DRF who underwent percutaneous K-wire fixation at Kamphaengphet Hospital between January and June 2023. Patients were allocated into two groups according to surgeon preference. The study group underwent a locked K-wire system without immobilization, while the control group underwent a nonlocked K-wire system and a short-arm slab. Postoperative wrist radiographs were taken immediately, at 2, 6, and 10 weeks. Wrist parameters (radial height, radial inclination, ulnar variance, and volar tilt) were measured and their differences were calculated with those of the immediate postoperative films. The data were statistically compared between the two groups.
Results: The mean radial height difference, radial inclination difference, and ulnar variance difference of the study group (n=26) were not different from those of the control group (n=31) at 2, 6, and 10 weeks (p<0.05). The mean volar tilt difference of the study group was significantly lower than the control group at 2, 6, and 10 weeks. One patient in the control group had revision surgery.
Conclusion: Using a locked K-wire system without immobilization for percutaneous K-wire fixation in DRF can maintain radial height, radial inclination, and ulnar variance similarly to the nonlocked K-wire system and short arm slab. It also significantly better maintains volar tilt throughout the 10-week follow-up period.

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How to Cite
Inta-ngam, T. (2023). Locked versus Nonlocked Percutaneous K-wire Fixation in Distal Radius Fractures Treatment: a Comparative Study for Maintenance of Postoperative Alignment. Lampang Medical Journal, 44(2), 29–39. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/266052
Original Article


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