| RadiographicPrediction of Redisplacement Risk after Augmented External Fixation with Percutaneous Pinning of Unstable Fractures of the Distal Radius |
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Min Bom Kim, Moon Sang Chung, Sang Ki Lee, Goo Hyun Baek, Young Min Lee, Seung Hwan Rhee |
| 외고정 및 경피적 강선 삽입술로 치료한 불안정 원위 요골 골절에서 재전위의 위험성에 대한 방사선학적 예측 |
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김민범, 정문상, 이상기, 백구현, 이영민, 이승환 |
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| Abstract |
Purpose
Because malunion of distal radius fractures often leads to pain, osteoarthritis and functional deficit, it is important to restore the anatomical alignment. The purpose of this study is to analyze radiologically the fracture cases of distal radius which were treated by augmented external fixation with supplemental pinning and to determine the risk factors for postoperative redisplacement. Materials and Methods: From 2005. 7 to 2007.6, 43 patients with unstable distal radius fractures were treated by augmented external fixation with percutaneous pinning. Immediately postoperatively, anatomical reduction was satisfactory in all cases. In the preoperative and final follow-up radiograph, various radiological landmarks were evaluated. Then, the correlation between clinicoradiological factors and redisplacement after surgery was analyzed statistically and the independent risk factors for redisplacement were determined. Results: Among 43 cases, redisplacement developed in 17 cases. By the univariate analysis, metaphyseal comminution (p=0.001), radial shortening (p=0.035) and radial inclination (p=0.039) were significantly correlated with redisplacement. By the multivariate logistic regression analysis with above three radiological factors, severe radial shortening more than 5 mm and high degree of metaphyseal comminution involving more than 1/3 of AP diameter of distal radius were determined to be the independent risk factors for redisplacement. Conclusion: External fixation with additional pinning is a relatively simple and effective method in the treatment of unstable fractures of the distal radius. But, in the cases with severe metaphyseal comminution and radial shortening, treatment with this technique may lead to redisplacement. So, it is important to decide which treatment option should be selected by evaluating the risk of redisplacement preoperatively. |
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