External fixation versus percutaneous pinning for unstable Colles' fracture - Equal outcome in a randomized study of 60 patients

60 patients > 20 years of age, with comminuted distal radial fractures of type Older 3 or 4, were randomly allocated to two treatment groups: external fixation a.m. Hoffmann or percutaneous Kirschner wire pinning combined with immobilization in a plaster cast. The groups were similar in age, gender, fracture type and dislocation. All patients were immobilized for 6 weeks and the outcome was assessed after 6 months. The groups showed similar results with respect to radiographic parameters and function. All fractures healed and no difference in complication rate was observed. We conclude that most unstable distal radial fractures, classified as Older's type 3 and 4, can be treated with percutaneous pinning and a plaster cast, which is simpler and cheaper than external fixation.