BUTTRESS PINNING IN THE UNSTABLE DISTAL RADIAL FRACTURE

Between 1989 and 1993, 20 patients with distal radial fractures were t reated with a buttressing technique felt to be safe, effective and sim ple. Out of the initial 20 patients, 16 have been followed-up and are reported. The technique uses an intramedullary styloid pin and a combi ned extramudulary-intramedullary dorsal buttress pin. The insertion te chnique and the use of a medial corner pin are illustrated. Results ar e evaluated from both final X-ray appearance as well as return of func tion using the five X-ray parameters of Abbasazadegan et al(1989) and the Mayo modification of the Green and O'Brien wrist score (Cooney ct al, 1987), The average score on return of function was 78 (two excelle nt, eight good, six fair). Final axial shortening averaged -1.4mm (+5 mm--4 mm), radial displacement averaged 0.68 mm (0 mm-5 mm), radial an gle averaged 24.75 degrees (18 degrees-34 degrees), dorsal angle avera ged +8.25 degrees (-5 degrees-25 degrees) and dorsal displacement aver aged +1.31 (0 mm-+12 mm). From this study rye recognize the need for a posterior medial pin, and that routine stress views after pinning can yield information concerning carpal instability, palmar instability a nd the need for bone grafting.