Clinical and Radiographic Outcomes in Distal Radius Fractures Using K-wires versus Fragment-specific Plates: A Prospective Interventional Study

Introduction: Orthopaedic practice frequently deals with Distal Radius Fractures (DRFs); however, the treatment strategies for optimal functional outcomes remain uncertain. K-wiring (Kirschner Wire) is a minimally invasive technique preferred for simple fractures, whereas Fragment-Specific Plating (FSP) offers targeted fixation for complex fracture patterns. Aim: To compare the functional and radiological outcomes of DRFs managed with K-wiring versus FSP. Materials and Methods: The present prospective interventional study was performed in the Department of Orthopaedics of a tertiary care hospital at Pune, Maharashtra, India, over 24 months from January 2023 to December 2024. A total of 40 patients were randomly categorised: K-wire group (n=20) and Plate group (n=20). Functional outcome was assessed with the Mayo modified wrist score, while radiological outcomes included radial inclination, radial height, and volar tilt. The patients were followed-up at 3, 6, and 12 months. Results: At three and six months, significantly greater proportion of patients in the Plate group had higher range of motion (p=0.003 and 0.029, respectively), and total scores (p=0.017 and 0.039, respectively). Similarly, at 6 and 12 months, patients in the Plate group had higher grip strength scores (p=0.025 and 0.010, respectively). Moreover, at three and 12 months, patients in the plate group had higher satisfaction (p=0.003) and higher pain scores (p=0.028), respectively. Both the groups had comparable radial inclination at all the intervals (p>0.05) and volar tilt at three months (p=0.116). At three months, the mean radial height was significantly greater in the plate group (p=0.012). Furthermore, at six and 12 months, the plate group demonstrated significantly higher radial height (p=0.003 and <0.001, respectively) and volar tilt (both p<0.001) compared to the K-wire group. However, the K-wire group was associated with significantly reduced operative time and shorter duration of hospital stay (both p<0.001). Conclusion: Both K-wiring and FSP are effective surgical methods for managing DRFs. However, FSP provides significantly better functional and radiological outcomes, and should be preferred, particularly in patients with complex DRFs.