Original Communications| Volume 25, ISSUE 6, P1064-1068, November 2000

External fixation of the distal radius: To predrill or not to predrill


      Using both clinical and laboratory studies we investigated whether predrilling before insertion of external fixation pins is necessary for use in treating distal radius fractures. Our clinical study included 50 consecutive external fixators (4.0- and 2.5-mm pins) using 100 predrilled and 100 direct-drilled pins placed in a randomized manner. There was no increased incidence of pin track infection or other pin problem with the direct-drilled technique. There were, however, significantly elevated temperatures with the direct-drilled technique. We therefore recommend predrilling even though the temperature differences in this bone with this fixator were not clinically evident. (J Hand Surg 2000;25A:1064-1068. Copyright © 2000 by the American Society for Surgery of the Hand.)


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        • Matthews LS
        • Green CA
        • Goldstein SA
        The thermal effects of skeletal fixation-pin insertion in bone.
        J Bone Joint Surg. 1984; 66A: 1077-1082
        • Green SA
        Complications of external skeletal fixation.
        Clin Orthop. 1983; 180: 109-116
        • Paley D
        Problems, obstacles, and complications of limb lengthening by the Ilizarov technique.
        Clin Orthop. 1990; 250: 81-104
        • Foster DE
        • Kopta JA
        Update on external fixators in the treatment of wrist fractures.
        Clin Orthop. 1986; 204: 177-183
        • Cooney WP
        External fixation of distal radial fractures.
        Clin Orthop. 1983; 180: 44-49
        • Riis J
        • Fruensgaard S
        Treatment of unstable Colles' fractures by external fixation.
        J Hand Surg. 1989; 14B: 145-148
        • Weber SC
        • Szabo RM
        Severely comminuted distal radial fracture as an unsolved problem: complications associated with external fixation and pins and plaster techniques.
        J Hand Surg. 1986; 11A: 157-165
        • Collinge MS
        • Goll G
        • Seligson D
        • Easley KJ
        Pin tract infections: silver vs uncoated pins.
        Orthopedics. 1994; 17: 445-448
        • Seitz Jr, WH
        • Putnam MD
        • Dick HM
        Limited open surgical approach for external fixation of distal radius fractures.
        J Hand Surg. 1990; 15A: 288-293
        • Schuind FA
        • Burny F
        • Chao EYS
        Biomechanical properties and design considerations in upper extremity external fixation.
        Hand Clin. 1993; 9: 543-553
        • Kaukonen J-P
        • Karaharju E
        • Lüthje P
        • Porras M
        External fixation of Colles' fracture.
        Acta Orthop Scand. 1989; 60: 54-56
        • Hertel R
        • Jakob RP
        Static external fixation of the wrist.
        Hand Clin. 1993; 9: 567-575
        • Fernandez DL
        • Jakob RP
        • Büchler U
        External fixation of the wrist: current indications and technique.
        Ann Chir Gynaecol. 1983; 72: 298-302
        • Heim U
        • Pfeiffer KM
        General techniques for the internal fixation of small fractures.
        in: Internal fixation of small fractures: technique recommended by the AO-ASIF group. Springer-Verlag, Berlin1988: 40-41
        • Matthews LS
        • Hirsch C
        Temperatures measured in human cortical bone when drilling.
        J Bone Joint Surg. 1972; 54A: 297-308