Ulnocarpal stabilization in the management of comminuted fractures distal end radius

BACKGROUND: Malunion due to progressive radial collapse during healing is a common complication following comminuted fracture distal radius treated by conventional methods. Many treatment modalities have been described with their own merits and demerits. Stabilization of ulnocarpal articulation is an effective method to prevent radial collapse during healing, and hence this study. MATERIALS AND METHODS: A prospective study of 200 patients of comminuted intraarticular fracture lower end radius between 20–75 years of age irrespective of sex, treated by closed reduction and percutaneous stabilization of ulnocarpal articulation and a well-molded above elbow POP cast for 6 weeks has been presented. Patients were evaluated at 1 year follow-up and functionally by Sarmiento's modification of Lindstrom criteria and Gartland and Werley's criteria. RESULTS: Excellent to good results were seen in 92%, fair in 6% and poor in 2% of the cases. Complications observed were, pintract infection (n = 6), malunion (n = 6), subluxation of the inferior radioulnar joint (n = 4) Sudeck's osteodystrophy (n = 3) and post-traumatic arthritis of the wrist (n = 3). CONCLUSION: Percutaneous fixation by this technique is an effective method to maintain the reduction, prevent radial collapse during healing, and to maintain the stability of the distal radioulnar joint even when the fracture is grossly comminuted, intraarticular, or unstable.