Comparison of Volar Plating and Percutaneous K-Wire Fixation in Distal Radius Fractures
DOI:
https://doi.org/10.70749/ijbr.v3i09.2227Keywords:
Intra-articular distal radius fracture, functional outcome, percutaneous K-wire, volar plateAbstract
Background: In the recent past, surgeons used external fixation or a combination of bone grafting, Kirschner wire (K-wire) augmentation, and restricted open reduction to manage intra-articular distal radius fractures. However, fragment-specific fixation has become a sustainable alternative with the recent emergence of locking implants especially made for the distal radius. Besides of these, there is no consensus in terms of optimum treatment approaches. Objective: To compare the functional outcome of volar plate versus percutaneous K-wire in intra-articular distal radius fracture. Study Design: Randomized Controlled Trial (RCT). Setting: Orthopedics Surgery Unit, Ghazi Khan medical college & Allama Iqbal Teaching Hospital Dera Ghazi Khan, Pakistan. Duration of study: The current research work was conducted from 31st January 2024 to 31st July 2025. Materials and Methods: After approval from the ethical review board, 70 patients fulfilling the inclusion criteria were enrolled for the study. Group A underwent treatment with volar plating while B with percutaneous K-wire. All patients were operated by the same consultant orthopedic surgeon under general anesthesia. On the 2nd post-operative day, patients were discharged with instructions on rehabilitation protocol. Patients were followed up to 3 months, while functional outcome was determined with the help of Gartland and Werley modification score. Results: Comparison of the functional outcome of volar plate versus percutaneous k-wire in intra-articular distal radius fracture shows 85.71 % (n=30) in Group-A and 74.29 % (n=26) in Group-B had excellent functional outcome, 14.29 % (n=5) in Group-A and 25.71 % (n=9) in Group-B had good functional outcome, p-value was 0.23 showing no significant difference. CONCLUSION: We concluded that functional outcome of volar plate is comparable when compared with percutaneous k-wire in intra-articular distal radius fracture, however, the difference is not significant
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1. Soerensen S, Larsen P, Korup LR, Ceccotti AA, Larsen MB, Filtenborg JT, Weighert KP, Elsoe R. Epidemiology of distal forearm fracture: a population-based study of 5426 fractures. Hand. 2024 Jan;19(1):24-9.
https://doi.org/10.1177/15589447221109967
2. Bergh C, Wennergren D, Möller M, Brisby H. Fracture incidence in adults in relation to age and gender: a study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area. PloS one. 2020 Dec 21;15(12):e0244291.
https://doi.org/10.1371/journal.pone.0244291
3. Smit AE, Meijer OC, Winter EM. The multi-faceted nature of age-associated osteoporosis. Bone Reports. 2024 Mar 1;20:101750.
https://doi.org/10.1016/j.bonr.2024.101750
4. Yordanov A, Vasileva-Slaveva M, Tsoneva E, Kostov S, Yanachkova V. Bone Health for Gynaecologists. Medicina. 2025 Mar 18;61(3):530.
https://doi.org/10.3390/medicina61030530
5. Sheen JR, Mabrouk A, Garla VV. Fracture healing overview. In Stat Pearls [Internet] 2023 Apr 8. StatPearls Publishing.
6. Miller TC, Fishman FG. Management of Monteggia injuries in the pediatric patient. Hand Clinics. 2020 Nov 1;36(4):469-78.
https://doi.org/10.1016/j.hcl.2020.07.001
7. Miller TC, Fishman FG. Management of Monteggia injuries in the pediatric patient. Hand Clinics. 2020 Nov 1;36(4):469-78.
https://doi.org/10.1016/j.hcl.2020.07.001
8. Kamal Y, Khan HA, Farooq M, Gani N, Lone AU, Shah AB, Latto IA, Khan MA. Functional outcome of distal radius fractures managed by barz ullah working classification. Archives of Trauma Research. 2015 Mar 20;4(1):e20056.
https://doi.org/10.5812/atr.20056
9. Tripathy SK, Khan S, Varghese P, Neradi D, Jain M, Patel H. Combined articular and ligament reconstructions in neglected fracture-dislocation of the knee. Journal of Clinical Orthopedics and Trauma. 2024 Jul 1;54:102475.
https://doi.org/10.1016/j.jcot.2024.102475
10. Kamal RN, Gomez GI, Schultz EA, Shapiro LM. The Safety of the Volar Intra articular Extended Window (VIEW) Approach for Intra-articular Distal Radius Fractures. HAND. 2025 May;20(3):394-401.
https://doi.org/10.1177/15589447231210926
11. Jain N, Iyer H, Gill S. Forearm fractures in adults. Surgery (Oxford). 2025 Jan 20.
https://doi.org/10.1016/j.mpsur.2024.12.002
12. Tai TH, Chu PJ, Lu KY, Wu JJ, Wong CC. Current Management and Volar Locking Plate Fixation with Bone Cement Augmentation for Elderly Distal Radius Fractures—An Updated Narrative Review. Journal of Clinical Medicine. 2023 Oct 27;12(21):6801.
https://doi.org/10.3390/jcm12216801
13. Tariq MA, Ali U, Uddin QS, Altaf Z, Mohiuddin A. Comparison between volar locking plate and Kirschner wire fixation for unstable distal radius fracture: a meta-analysis of randomized controlled trials. Journal of Wrist Surgery. 2024 Oct;13(05):469-80.
https://doi.org/10.1055/s-0043-1768235
14. Muhammad G, Shahwani MB, Ghilzai AK, Jamal S, Kakar KK, Luqman M, Khan A. Outcome of Volar Plate in Patients with Intra Articular Distal Radius Fracture. Indus Journal of Bioscience Research. 2025 Jan 10;3(1):197-202.
https://doi.org/10.70749/ijbr.v3i1.470
15. Mazar S, Shah MI, Panhwar SK, ur Rahman SA. Functional Outcomes of Close Reduction With K-wires Vs Open Reduction and Internal Fixation in Distal Radius Fractures. Pakistan Journal of Medicine and Dentistry. 2022;11(3):44-50.
https://doi.org/10.36283/pjmd11-3/008
16. Siwach P, Singh SV, Puri G, Singh J. Functional Outcome of Intra-Articular Fracture of Distal End Radius Treated with External Fixator; A Prospective Study. Current Health Sciences Journal. 2025 Mar 31;51(1):141.
17. Fok MW, Klausmeyer MA. Volar Plate Fixation of Intra- Articular Distal Radius Fractures: A Retrospective Study. J Wrist Surg 2013;2:247–54.
https://doi.org/10.1055/s-0033-1350086
18. Fok MW, Klausmeyer MA, Fernandez DL, Orbay JL, Bergada AL. Volar plate fixation of intra-articular distal radius fractures: a retrospective study. Journal of wrist surgery. 2013 Aug;2(03):247-54.
https://doi.org/10.1055/s-0033-1350086
19. Youlden DJ, Sundaraj K, Smithers C. Volar locking plating versus percutaneous Kirschner wires for distal radius fractures in an adult population: a meta-analysis. ANZ J Surg 2018;
https://doi.org/10.1111/ans.14903
20. Costa ML, Achten J. Percutaneous fixation with Kirschner wires versus volar locking plate fixation in adults with dorsally displaced fracture of distal radius: randomised controlled trial. BMJ 2014;349.
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