FRACTURE OF THE DISTAL RADIUS - A PROSPECTIVE COMPARISON BETWEEN TRANS-STYLOID AND KAPANDJI FIXATIONS

We performed a prospective study on 96 patients with extra-articular o r intra-articular fractures of the distal radius with a dorsally displ aced posteromedial fragment, After closed reduction, we compared trans -styloid fixation and immobilisation with Kapandji fixation and early mobilisation, Forty-two patients of mean age 57.1 years +/- 18.1 (SD) were treated by trans-styloid K-wire fixation and 45 days of short-arm cast immobilisation. Fifty-four patients of mean age 57.7 years +/- 1 8.7 (SD) had Kapandji fixation and immediate mobilisation according to the originator. All the patients had clinical and radiological review at about six weeks and at 3, 6, 12 and 24 months after the operation, Pain, range of movement and grip strength were tested clinically, and changes in dorsal tilt, radial tilt, ulnar variance, and radial short ening were assessed radiologically. Statistical analysis was applied t o comparisons with the normal opposite wrist. Pain and reflex sympathe tic dystrophy were more frequent after Kapandji fixation and early mob ilisation, but the range of motion was better although this became sta tistically insignificant after six weeks, The radiological reduction w as better soon after Kapandji fixation, but there was some loss of red uction and increased radial shortening during the first three postoper ative months. The clinical result at two years was similar in both gro ups.