Comparison of treatment modalities for distal radius fractures in terms of functional outcomes pain management and grip strength

Distal radius fractures are among the most common fractures in adults and require treatment approaches tailored to fracture characteristics and patient needs. The primary objective of this study was to compare the 6-month Patient-Rated Wrist Evaluation (PRWE) score across three treatment modalities—closed reduction and short-arm casting, external fixation, and volar plate fixation. The null hypothesis was that there would be no difference in PRWE outcomes among the three groups. Secondary objectives included evaluating pain intensity, functional disability, grip strength, and wrist range of motion (ROM). This retrospective comparative study included 60 adults with distal radius fractures treated between January 2022 and June 2024. Patients were divided into three equal groups (n = 20 each) based on the treatment method. The primary outcome measure was the PRWE score at the 6-month follow-up. Secondary outcomes included the Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score, grip strength, and wrist ROM. At 6 months, statistically significant differences were observed among the three groups for all outcome measures (p < 0.001). The volar plate group had lower PRWE scores (19.2 ± 4.8) than the external fixation group (28.4 ± 6.3) and the casting group (38.6 ± 5.2). Similar patterns were observed in qDASH and VAS scores. Differences in PRWE and VAS scores between the volar plate and casting groups exceeded established minimal clinically important difference (MCID) thresholds. Grip strength and ROM values also differed significantly among groups; however, no MCID thresholds were applied for these parameters. Significant differences in 6-month PRWE, qDASH, and VAS scores were observed among the three treatment modalities. The volar plate group achieved the lowest disability and pain scores, followed by external fixation. These findings highlight measurable functional and symptomatic differences at short-term follow-up; however, long-term outcomes should be evaluated in future prospective studies.