MINI-JESS EXTERNAL FIXATION VERSUS PERCUTANEOUS KIRSCHNER WIRING IN COMMINUTED DISTAL RADIUS FRACTURES: A PROSPECTIVE COMPARATIVE ANALYSIS OF STABILITY, UNION, AND FUNCTIONAL RECOVERY

Abstract

Background Comminuted distal radius fractures pose serious problems as far as stability in fixation, maintenance of anatomical reduction and restoration of optimal wrist functioning are concerned. These fractures are treated using different surgical methods with the most common two being Mini-JESS external fixation and percutaneous Kirschner wire fixation, especially in resource constrained environments. But very little comparative data is available on their efficacy in terms of stability, fracture union and functional restoration.

Objectives The current research had the purpose to prospectively compare terms of Mini-JESS external fixation and percutaneous Kirschner wire fixation in treatment of comminuted distal radius fractures with special focus to the aspects of radiological stability, time to union, functional outcomes, and complication rates.

Methods This was a prospective comparative study which was done on adult patients who had closed comminuted fractures of the distal radius which were surgically treated in a tertiary care centre. The patients were divided into two groups Group A which received Mini-JESS external fixation and Group B which received percutaneous Kirschner wire fixation. Radiological measurements such as radial height, radial inclination and volar tilt were measured at intervals. Clinical and radiographic assessment was done on fracture union. Standardized scoring of wrist function using scoring systems, range of motion and grip strength were used to measure functional outcomes. The complications that are related to both methods were documented and compared.

ResultsMini-JESS patients undergoing external fixation surgery showed a better maintenance of radiological positioning and showed increased fracture stability in patients undergoing external fixation surgery as opposed to percutaneous Kirschner wire fixation. There was no significant difference in the mean time to union in the two groups. There was a slight improvement in functional outcome scores and range of motion in the wrist in Mini-JESS group at the final follow-up. The most frequent complication was pin tract infection in both groups, but it happened a little more in the case of external fixation, whereas loss of reduction was experienced more in the K-wire fixation group.

ConclusionMini-JESS external fixation offers superior fracture stability and enhanced remedial recovery to percutaneous Kirschner wire fixation in comminuted distal radius fractures, and does not definitely escalate difficultship. It is a secure and economical surgical intervention, especially in case of unstable fracture pattern in which reduction is paramount.