Intrafocal pinning first described by Kapandji was originally indicated for extra-articular fractures of the distal radius in young patients. We Modified the procedure for application to elderly patients. Three Kirschner wires were inserted through small incisions. The dorsal intramedullary pin was inserted first through the fourth dorsal compartment. The radial pin was then inserted between the first and second dorsal compartments.
Finally the palmar pin was inserted from the radial side of the radial artery. The ends of the Kirschner wires were bent and impacted to the cortex to avoid skin irritation.
We observed 27 (16 original procedures and 11 modified procedures) patients aged over 65. The number of patients within the normal range of the palmar tilt (0 to 22 degrees) was 7 for the original procedure and 10 for the modified procedure. That within the normal range of the radial inclination (16 to 22 degrees) was 7 and 11 respectively. 11 patients were evaluated by the Saito's demerit point system. There were 1 excellent and 5 good for the original procedure and 5 excellent for the modified procedure. The number of patients with complications caused by the Kirschner wires was 8 for the original procedure and 1 for the modified procedure. The results suggest modified intrafocal pinning method maintains better reduction and reduces complications by the Kirschner wires.