Comparative analysis of closed reduction and percutaneous pinning versus conventional closed reduction with casting in extra-articular fractures of distal end radius

Gaurav singh, Prateek Rastogi, Harish Kodi, Rakesh Vishwakarma, Ajit Singh


Background: Distal radius fractures are very common. Closed reduction and casting are the conventional non-operative treatment option available while plate fixation, external fixation and closed reduction with percutaneous pinning are a few surgical options available to the surgeon.

Methods: A prospective comparative study of one year was conducted in the Department of Orthopaedic Surgery. A total of 40 patients of distal radial fracture fulfilling the inclusion criteria and giving their consent for inclusion in the study were randomly allocated to either closed reduction (n = 20) or closed reduction with percutaneous K-wire (20). Patients were followed up to 6 months and radiological and functional outcome was compared between two groups.

Results: On global assessment using Gartland and Werley criteria, median score of K-wire group was 7.5 which indicated that majority of patients had score <8, thus indicating a good outcome whereas in closed reduction cast group, median score was 13.50, thus indicating that majority of patients had scores in the fair to poor grade. None of the patients in K-wire group had score above 18, thus indicating that all the patients in this group had shown a fair treatment response. Statistically, the difference between two groups was significant too.

Conclusions: The present study thus establishes that the immediate post-operative morphological/anatomical and 6 month functional and morphological outcome of closed reduction with K-wire is better as compared to closed reduction with cast.


Distal radius, K wire, Fracture

Full Text:



Pogue DJ, Vegas SF, Patterson RM, Peterson PD, Jenkins DK, Sweo TD, Hokanson JA. Effects of distal radius malunion on wrist joint mechanics. J Hand Surg Am. 1990;15:721-7.

Colles A. On the fracture of the carpal extremity of the radius. Edinb Med Surg J. 1814;10:181.

Frykman G. Fracture of the distal radius including sequelae--shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand. 1967;108:3.

Melone CP. Open treatment for displaced articular fractures of the distal radius. Clin Orthop Relat Res 1986;202:103-11.

Muller ME, Nazarian S, Koch P. AO Classification of fractures. Springer-Verlag, Berlin; 1987. Available at

Gartland JJ, Jr, Werley CW. Evaluation of healed Colles' fractures. J Bone Joint Surg Am. 1951;33(4):895-907.

Bacorn RW, Kurtzke JF. Colles' fracture: a study of two thousand cases from the New York states Compensation Board. J Bone Joint Surg Am. 1953;35:643-58.

Fernandez DL, Jupiter JB, editors. Fractures of the distal radius: A practical approach to management. New York, NY: Springer-Verlag; 1996.

Fernandez DL. Correction of post-traumatic wrist deformity in adults by osteotomy, bone grafting and internal fixation. J Bone Joint Surg Am. 1982;64:1164-78.

Fernandez DL. Radial osteotomy and Bowers arthroplasty for malunited fractures of the distal end of radius. J Bone Joint Surg Am. 1988;70:1538-51.

Swenson AL. The treatment of supracondylar fractures of the humerus by Kirschner wire fixation. J Bone Joint Surg Am. 1948;30:993-7.

Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years' experience with long-term follow-up. J Bone Joint Surg Am. 1974;56(2):263-72.

Shivakumar HB, Chanappa TS, Yatish R, Lohith H. Functional outcome of surgical management of intra-articular fractures of distal end of the radius by internal fixation. J Evol Med Dental Sci. 2014;3(20):5478-83.

Chen CE, Juhn RJ, Ko JY. Treatment of distal radius fractures with percutaneous pinning and pin-in-plaster. Hand. 2008;3:245-50.

Bagul RR, Deshmukh A, Salgia A, Agarwal T, Rajani D, Sooknundan M. Comparative evaluation in the measurement of the radial height, radial inclination, and ulnar variance in fracture distal end radius treated conservatively by closed reduction and cast and closed reduction, Kirschner wire and cast. Med J DY Patil Univ. 2014;7:590-5.

Venkatesh RB, Maranna GK, Narayanappa RKB. A comparative study between closed reduction and cast application versus percutaneous k- wire fixation for extra-articular fracture distal end of radius. JCDR. 2016;10(2):RC05-RC09.

Ozcan M, Memisoglu S, Copuroglu C, Saridogan K. Percutaneous Kirschner Wire fixation in distal radius metaphyseal fractures in children: does it change the overall outcome? Hippokratia 2010;14(4):265-70.