Assessment of Radiological Outcomes of Extra-articular Distal End Radius Fractures Treated by Volar Locking Plating versus Percutaneous K-wire and Cast Application: A Retrospective Observational Study

Introduction: Extra-articular distal end radius fractures are among the most commonly encountered orthopedic injuries. Closed reduction with percutaneous K-wiring and cast application is a widely used method of treatment due to its minimally invasive nature and cost-effectiveness, although it requires prolonged immobilisation and carries a risk of malunion. Open Reduction and Internal Fixation (ORIF) using volar locking plates has emerged as an alternative by offering rigid fixation and enabling early mobilisation. Aim: To compare the radiological outcomes- specifically radial height, radial inclination, and volar tilt between percutaneous Kirschner (K) wire fixation and volar plate fixation methods in extra-articular distal end radius fractures treatment. Materials and Methods: This is a retrospective observational study conducted at Symbiosis Medical College for Women (SMCW), Pune, Maharashtra, India, involving 81 patients aged above 18 years from January 2024 to March 2024. These patients were treated between January 2021 and December 2023 for extra-articular distal radius fractures (AO Type-2R3A2 and AO Type-2R3A3). Patients were divided into two groups: 37 were treated with closed reduction, K-wiring, and casting, while 44 underwent volar plating via the Henry approach. Postoperative radiographs at three months were assessed for radial height, radial inclination, and volar tilt using the Picture Archiving and Communication System (PACS). Data analysis was performed using Statistical Package for the Social Sciences (SPSS) Statistics software, version 20, with statistical significance set at p<0.01. Results: The mean age of patients in the K-wire group was 54.72 years (range: 18-87), while the mean age for the volar plating group was 42.59 years (range: 20-73). There were 11 males (29.73%) and 26 females (70.27%) in the K-wire group, whereas the volar plating group included 29 males (65.91%) and 15 females (34.09%). The results indicated that volar plating achieved significantly better restoration of radial height, radial inclination, and volar tilt (p<0.001**), suggesting a lower risk of malunion compared to K-wiring. Conclusion: It is concluded that ORIF with volar plating yields superior radiological outcomes compared to closed reduction with percutaneous K-wiring and cast application in the management of extra-articular distal end radius fractures.