Distal end radius fractures represent one of the commonest fractures treated in emergency department. Though management of distal end radius fractures has changed over the period of time from cast immobilization to operative intervention, there are conflicting data about long term relationship regarding radiographic parameters and patient report outcome. We compared the outcome of fractures of the lower end radius treated with closed reduction and cast immobilization and those treated with percutaneous K wire fixation and immobilization in cast in neutral position.

Aims and Objectives: To study postoperative functional outcome and complications in patients treated for extra articular fracture of distal end of radius and to compare the role of closed reduction and cast and percutaneous K wire fixation and cast application in management of fracture distal end of radius.

Materials and Methods: 40 cases of extraarticular lower end of radius fracture were treated. These 40 cases were divided randomly in two equal groups consisting of 20 patients each. One group was treated with  closed reduction and below elbow cast and other group by percutaneous  K wire fixation and below elbow cast.In both the groups radiological and clinical evaluation was done by taking serial AP and lateral view of wrist joint at 4 weeks, 8weeks and finally at 12 weeks. The assessment of results were made using the demerit score system of Gartland and Werley based on objective and subjective criteria, residual deformity and complications.

Results: Our results showed excellent outcome in 8 patients treated by percutaneous K wire fixation and  in 6 patients treated by closed reduction and cast alone. When compared both groups anatomical reduction was maintained better in K wire group. Patients in cast group developed progressive dorsal angulation, loss of radial length and radial inclination. K wire group had statistically significant better radiological outcome except for ulnar variance and bone healing than cast group. However functional outcome was similar in both groups

Keywords: Closed Reduction Cast versus percutaneous  K wire fixation, extra articular radial fractures.

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Dr Sanjay Rajkamal Bharti

Shri Vasantrao Naik Government Medical College [SVNGMC] Yavatmal, Maharashtra, India

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