HISTORY AND PERSPECTIVE OF K-WIRE OSTEOSY NTHESIS IN THE UNSTABLE DISTAL RADIUS FRACTURE (COLLES TYPE)

Concerning the operative therapy of the distal radius fracture (Colles type) we developed an osteosynthesis which consists of a combination of the conventional K-wire fixation (KWF) of Willenegger and the dynam ic KWF of Kapandji. This minimally invasive procedure enables a functi onal therapy instantly without risk of secondary dislocation. In a pro spective study of 110 patients including following-up examination (n = 72) good anatomical reconstruction was demonstrated. The range of mot ion at the wrist was only minimally compromised and allowed full funct ion. A biomechanical study of the combined KWF showed that in order to achieve a good dorsal stability, the fragment zone has to be reduced in the dorsal cortical defect. Dorsal stability is achieved mainly by the dynamic KWF, while volar stability by the conventional KWE As a re sult of the clinical and biomechanical results we developed four bioco mpatible forms of osteosynthesis. These obtained a stability comparabl e to the combined KWO which was possible only by an increased operativ e effort and material costs.