TECHNIQUETreatment of Unstable Extra-Articular Distal Radius Fractures by Modified Intrafocal Kapandji MethodRuschel, Paulo Henrique MD1; Albertoni, Walter Manna MD, PhD2Author Information 1Hand Surgery Unit, Orthopaedic Department, Santa Casa Hospital, Porto Alegre, Rio Grande do Sul, Brazil 2Orthopaedic Department, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil Address correspondence and reprint requests to Paulo Henrique Ruschel, MD, Rua Leopoldo Bier, 825/305 Porto Alegre, RS, Brazil. E-mail: [email protected]. Techniques in Hand and Upper Extremity Surgery: March 2005 - Volume 9 - Issue 1 - p 7-16 doi: 10.1097/01.bth.0000153633.61905.f7 Buy Metrics Abstract The authors prospectively assess the results of surgically treated, unstable extra-articular distal radius fractures from 29 patients with good bone quality. Mean age was 49 years, ranging from 22 to 69 years; the female gender was the most frequently affected (58.6% of the cases). Surgical fixation was indicated for fractures presenting an angulation above 20°, marked dorsal comminution, and radius shortening in excess of 10 mm on initial x-rays (anteroposterior and lateral views). The Kapandji technique, with intrafocal, nonthreaded Kirschner wires, was employed. Clinical data assessed anatomic aspects according to Scheck, functional aspect after Gartland and Werley, strength by Scheck's methods, and esthetic by Frykman's criteria. Functional assessment, according to Gartland and Werley, revealed 72.1% of excellent and good results at 3 months; 89.7% at 6 months; and 96.6% at 12 months. Immediate postoperative reduction was not maintained at the final follow-up at 12 months; however, that loss was not severe, and the anatomic outcome was good and excellent in 96.6% of the cases. Six patients presented complications. Four patients presented reflex sympathetic dystrophy; 1 patient had a superficial Kirschner wire infection, and another patient had radial nerve superficial branch paresthesia. The employed technique showed to be effective in the treatment of unstable, extra-articular fractures of the distal radius. It is easy to learn and to perform. The device employed has a low cost and is widely available in operation rooms. © 2005 Lippincott Williams & Wilkins, Inc.