Closed Reduction and Percutaneous Pinning of Distal Radius Fracture Without Intra-Operative X-Ray

Abstract

Background: Although intra-operative X-ray is deemed necessary for closed reduction and percutaneous pinning of distal radius fracture, it is not uncommon, in several operative rooms in developing countries, to encounter situations when the access to image intensifier or even portable X-ray emitter is impossible.
Objectives: The aim of the present study was to assess the quality of reduction and pin insertion of distal radius fractures treated by closed reduction and percutaneous pinning without application of intraoperative X-ray.
Patients and Methods: Attempts were made to restore volar tilt and radial height by palpating of dorsal cortex of distal radius and styloid of radius, after infraclavicular block, by closed reduction and percutaneous pinning for 31 patients with types A2, A3 and non-displaced B1 distal radius fractures (AO classification). After careful pinning, dressing and splinting, X-rays were obtained in the radiology department, immediately.
Results: Totally, nine male and seven female patients, with mean age of 39.2 years (SD: 16.6; range: 13 - 58 years), were included in the study. Parameters of reduction were acceptable in all patients. Three complications (18.75%) occurred, concerning placement of pins in three patients (wrong placement of pins from styloid of the radius, excessive length of pin with skin irritation at its tip and a pin penetration to radio scaphoid joint.
Conclusions: Closed reduction and percutaneous pinning of distal radius fracture may be possible in the absence of intraoperative X-ray by the risk of several insignificant complications.