Novel technique: Retractor-assisted closed reduction combine
Percutaneous pinning fixation (PCP) has been used for the treatment of distal radius fractures for decades, especially in the elderly with fragile soft tissue. This study innovatively applied the Steinmann pin retractor for closed reduction combined with PCP, to provide a new protocol for the treatment of distal radius fractures.

49 patients out of 57 that met the inclusion criteria were included in our retrospective cohort study. 16 patients were treated with Steinmann pin retractor-assisted closed reduction combined with PCP (S-PCP), and 19 patients were treated with the manipulative reduction combined with PCP (M-PCP), and 14 patients were treated with the manipulative reduction combined with cast splint (M-C). All these patients received a positive postoperative radiological and clinical evaluation.

Results:
--All the patients were followed up for a minimum of 2 years. The radiological parameters in each group improved significantly postoperative (posttreatment).

--In the S-PCP group, the values of radial height and ulnar variance significantly improved as compared to the M-PCP and M-C groups.

--While the patients in the M-C group experienced significant re-displacement at the first and last follow-ups, in the S-PCP group, the range of wrist motion including extension, radial deviation, and supination; ulnar deviation and QuickDASH score; and grip strength, pronation, and modified Mayo wrist score also improved as compared to the M-PCP group, M-C group, or both groups at the last follow-up.

In conclusion, S-PCP enhances fractures and wrist function, and can work as a successful treatment in the elderly with limited dorsal comminulation for A2 and A3 type of distal radius fractures, including intraarticular fractures less than 2mm.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02556-6
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