Delattre O, Saillant G, Lemoine J, Benazet J P, Roy-Camille R
Service de chirurgie orthopédique, Hôpital de la Pitié-Salpêtrière, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1994;80(2):94-107.
62 fractures of the distal radius were treated by pin fixation: Kapandji's intra focal pinning in 28 cases (Group "K") and Py's elastic pinning in 34 cases (group "P"). The two groups were comparable as to the type of fractures (Castaing classification). Theoretical principles were analyzed and compared.
Final radiographic results showed the same proportion (75 per cent) of anatomic reduction in both groups. There were 21.4 per cent (6/28) hyporeductions in group K, and 23.5 per cent (8/34) hypereducations in group P. Hyporeduction was moderate with good functional results. Hypereduction in group P was often associated with bad functional results, 5 out of the 6 bad results of all the cases. The functional result, with a follow up of 7 months (4 to 10), was 76 per cent of excellent and good results, 85 per cent in group K, 70 per cent in group P.
Kapandji's technique seemed more reliable than Py's technique. We propose a technical variation to minimize hyporeduction in Kapandji's technic: increasing the pin's angulation.
Py's technic conserves one indication: intra operative failure of Kapandji's technique in very osteoporotic bone.
62例桡骨远端骨折采用钢针固定治疗：28例采用卡潘迪（Kapandji）关节内穿针固定（K组），34例采用皮伊（Py）弹性穿针固定（P组）。两组骨折类型（卡斯坦（Castaing）分类）具有可比性。对理论原则进行了分析和比较。
最终影像学结果显示两组解剖复位比例相同（75%）。K组有21.4%（6/28）复位不足，P组有23.5%（8/34）复位过度。复位不足程度较轻，功能结果良好。P组复位过度常伴有不良功能结果，所有病例中6例不良结果中有5例为此情况。随访7个月（4至10个月）的功能结果显示，优良率为76%，K组为85%，P组为70%。
卡潘迪技术似乎比皮伊技术更可靠。我们提出一种技术改进方法，以尽量减少卡潘迪技术中的复位不足：增加钢针角度。
皮伊技术保留了一个适应证：在非常骨质疏松的骨中卡潘迪技术术中失败。
