External pin fixation for unstable Colles' fractures

Abstract

During a five-year period, a double-pin Roger Anderson apparatus, with pins perpendicularly placed in the second and third metacarpals and in the distal part of the radius, was applied in 130 patients with an unstable Colles fracture. Sixty of the 130 were followed for two years. Shortening was limited to a median of two millimeters and dorsal angulation, to a median of 3 degrees. Wrist dorsiflexion averaged 58 degrees, and volar flexion averaged 50 degrees. Pronation and supination had an average loss of 5 degrees when compared with the uninjured side. Repeat reduction was required in only three patients. Patient assessment revealed that 85 per cent of the patients had good results; 12 per cent, fair; and 3 per cent, unsatisfactory. Objective analysis (McBride system) revealed that 90 per cent had good to excellent results; 8 per cent, fair; and 2 per cent, poor. Ninety-two per cent had no pain, 89 per cent had no deformity, and the mean grip strength was twenty kilograms. Sixteen patients had complications; seven of the sixteen had pin loosening, which occurred most frequently late during the course of treatment and without adverse sequelae.