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Distal Radius Frx: Kapandji’s Technique

- See: distal radius fracture menu   / percutaneous pin fixation

- Discussion:
    - Kapandji's Technique / Intra Focal Pin Fixation:
           - a technique in which pins are inserted into the fracture site which are then used to pry the distal fragment into optimal position;
           - indicated for extra-articular distal radial fractures w/ good bone stock;
           - using flourscopy, pins are driven into the frx site in a proximal to distal direction;
           - correction of dorsal angulation:
                  - intrafocal pin is inserted from the dorsal-ulnar side to reestablish the volar tilt
                  - drive pins into the dorsal cortex, apply a levering action in a volar direction, and drive into the volar cortex;
           - correction of radial inclination:
                  - to correct loss of radial inclination, drive pins along the radial cortex;
                  - inserted from the volar radial side to reestablish the radial inclination and the radial length
           - the pins are then levered until the proper anatomy is restored, and subsequently the pins are then driven proximally and oblique into the cortex of the proximal fragment;
           - disadvantages:
                  - intra-focal pinning by itself does not provide rigid fixation and often requires concomitant external fixation;
                  - propensity for collapse in older patients, especially when comminution is present (since frx fragments can slide along the pin

[Internal fixation by double intrafocal plate. Functional treatment of non articular fractures of the lower end of the radius (author's transl)].

Intrafocal (Kapandji) pinning of distal radius fractures with and without external fixation.      

Intrafocal (Kapandji) pinning of unstable distal radius fractures: a preliminary report. The unstable distal radial fracture one year post 

Kapandji intrafocal pinning

Treatment of distal radius fractures with intrafocal (kapandji) pinning and supplemental skeletal stabilization

Two procedures for Kirschner wire osteosynthesis of distal radial fractures. A randomized trial.

Results of distal radial fractures treated by intra-focal pin fixation