European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Fractures of the distal end radius are the most common fractures of the upper extremity, encountered in practice and constitute 17% of all fractures and 75% of all forearm fractures. The fundamental principle of fracture treatment is to obtain accurate fracture reduction and then use an immobilization method that will maintain and hold that reduction. The most common surgical treatment of closed distal radius fractures is by Kirschner-wires (K-wires) or volar locking plates, with the latter gaining popularity these days. In this study, we compared functional outcomes of K-wires with those of volar locking plates.
Methods: A prospective comparative study of 50 patients with dorsally displaced distal radius fractures treated with K-wiring and volar locking plates (25 cases in each group) was performed. An initial clinical evaluation was done pre-operatively followed by fracture fixation and was further evaluated functionally and radiologically post-operatively. Functional results were analyzed by the modified Demerit point system of Gartland and Werley, anatomical results were analyzed by Sarmiento’s modification of Lindstrom criteria, and radiological assessment was done as per criteria given by NANA et al.
Results: Radiologically and anatomically volar plate had better results as compared to k-wire, during the initial follow-up of fractures of the distal radius. The volar plate also dominated over k-wires in terms of functional results but at 6 months there was very little difference seen functionally. Both techniques provide great clinical results, without a clear superiority of either fixation method for the surgical management of distal radius fractures.
Conclusion: We conclude that locking plates offer no functional advantage over the older and economical method of Kirschner wire fixation for patients with displaced fractures of the distal radius.