Comparative Study between Bicolumnar Plating and Threaded K Wire in Geriatric Patient with Osteoporosis and Multiple Comorbid Patients

Background: Managing distal humerus fractures in geriatric patients with osteoporosis and multiple comorbidities is challenging due to poor bone quality and high surgical risk. Bicolumnar plating provides rigid fixation, potentially allowing for early mobilization, while threaded K-wire fixation is less invasive but may offer less initial stability. This study aims to compare the clinical outcomes of these two fixation methods. Methods: A total of 48 geriatric patients with distal humerus fractures were enrolled in this comparative study. The participants were divided into two groups: 22 patients underwent bicolumnar plating (Plating group), and 26 patients were treated with threaded K-wire fixation (K-wire group). The primary outcomes assessed were mobility and range of motion at 3 months and 12 months postoperatively. Complications were also recorded. Data were analyzed using SPSS software, with a significance level set at p<0.05. Results: At 3 months postoperatively, the Plating group exhibited superior mobility and range of motion, with a mean flexion of 120° and a mean extension deficit of 10°, compared to 100° and 20°, respectively, in the K-wire group. However, by the end of 12 months, both groups demonstrated similar outcomes, with a mean flexion of 110° in the Plating group and 108° in the K-wire group, and comparable extension deficits of 15° and 17°, respectively. No significant differences in complications were observed between the two groups. Conclusion: Bicolumnar plating offers better short-term functional outcomes compared to threaded K-wire fixation. However, both methods result in similar long-term outcomes, making K-wire fixation a viable alternative for geriatric patients with significant comorbidities due to its less invasive nature.