[Over-reduction after distal radius fracture pinning in young active patients: Prevention by multiple mixed pinning]. / Hyperréduction après brochage des fractures de l'extrémité distale du radius chez le sujet jeune actif. Prévention par brochage mixte multiple.

Over-reduction is a classical complication following pinning of distal radius fractures. Indeed, the pinning techniques derived from Kapandji's technique do not allow anterior stabilization. A literature review and our experience show that it is an underestimated complication that can affect up to one-third of cases, but that is well tolerated if the anterior tilt is less than 20°. Excessive angulation of the dorsal intrafocal K-wires becomes a significant risk factor beyond 60°. Volar comminution of the fracture is an obvious predisposing factor. We will outline our ideas on the topic and present a new pinning technique, which has reduced the over-reduction rate to below 3 %: multiple mixed pinning combines two dorsal intrafocal K-wires with two trans-styloid K-wires along the anterior and posterior cortices of the radius to provide true sagittal stabilization of the fracture. This technique is suitable for fractures without major instability or associated anterior comminution-Milliez types 1 and 2 are its best indications. In our practice, there still is a place for pinning of non-complex fractures in young active subjects. More than 20° malunion in flexion can lead to symptoms; in this instance, isolated opening osteotomy of the radius is the most suitable technique.

["Floating interphalangeal joint". A case report]. / « Articulation interphalangienne flottante ¼. À propos d'un cas.

We report the case of a combination of closed extra-articular phalangeal fractures of the thumb, creating a floating interphalangeal joint. The lesions described were the result of a direct trauma to the thumb during the earthquake in Haiti in January 2010. It was fixed seven days after the trauma using a percutaneous external fixation with a dorsal frame or Martinique's "Ti'fix" - a modification of the Beaubourg fixator. We describe this simple, economical and improved quality method of fixation. Consolidation permitted the removal of the external fixator a month after surgery, followed by early mobilization. We report the functional and aesthetic results at 1-year follow-up.