Comparison of Volar Plating and Percutaneous K-Wire Fixation in Distal Radius Fractures

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