A Comparative Study of Functional Outcomes Between Conservative Management and Volar Locking Plate Fixation in Extra-articular Distal Radius Fractures

Background Fractures of the distal radius are among the most common upper limb injuries. Management options range from closed reduction with casting to open reduction and internal fixation (ORIF) using volar locking plates. The optimal treatment approach for extra-articular fractures remains debated. Objective The objective of this study was to compare functional and radiological outcomes between conservative treatment and volar locking plate fixation in extra-articular distal radius fractures. Methods A prospective comparative cohort study was conducted on 60 patients with extra-articular distal radius fractures, allocated into two equal groups: Group A underwent closed reduction with plaster immobilization, and Group B underwent ORIF with a volar locking plate. Functional outcomes were assessed using the Green and O'Brien scoring system at regular intervals up to six months. Radiological evaluation included radial length, volar tilt, and radial inclination. Complications were recorded. Statistical analysis was performed using the chi-square test and independent t-test, with p<0.05 considered significant. Results The mean age was comparable between groups (p>0.05). At final follow-up, Group B demonstrated significantly better mean Green and O'Brien scores (88.2 ± 6.1) compared to Group A (76.5 ± 8.4) (p<0.001). Radiological parameters were closer to anatomical norms in Group B (p<0.05 for radial length and volar tilt). Complications were more frequent in Group A, including malunion and stiffness, whereas Group B had occasional implant-related irritation. Conclusion Within the limits of a non-randomized design, volar locking plate fixation yields superior functional and radiological outcomes compared to conservative treatment for displaced extra-articular distal radius fractures, with fewer late complications and earlier return of function.