Intra-articular Fracture of the Distal Radius Treated by Intrafocal Pinning.

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We treated 16 patients (10 men and 6 women) with intra-articular fractures of the distal radius by intrafocal pinning which was reported by Kapandji at 1976. The age at surgery range from 17 to 77 years, mean 41.3 years. There were 12 communited Colles fractures, 2 volar Barton fractures, and 2 comminuted Smith fractures. Follow-up ranged from 2 to 33 months with a mean of 12.3 months.The roentgenographic changes of radial inclination, palmar tilt, ulnar variance, and step-off were measured just after pinning and at final follow-up. Roentgenographic results and clinical results were evaluated using Saito's criteria.Radial inclination averaged 24.6° after reduction and 22.6° at follow-up. Palmar tilt averaged 8.3° after reduction, changing to 9.0° at follow-up. Mean ulnar variance was 0.6mm and mean step-off was 2mm. These values did not change after reduction and at follow-up. Those values were within acceptable range after Saito's criteria. Clinical results were excellent in 7, good in 9. None showed fair or poor results.Intrafocal pinning has only been indicated for extra-articular fractures and intra-articular fractures with moderate dorsal comminution. Our surgical results justify our expanded indication for other comminuted fractures of the distal radius. We think that intrafocal pinning is the method of choice for extra-and intra-articular fractures of the distal radius.