Closed Reduction and K-Wire Fixation of Intra Articular Distal Radius Fracture Versus Volar Plating: A Prospective Comparative Study
Keywords:
Distal radius fracture; Volar locking plate; Kirschner wire; Open reduction and internal fixation; Percutaneous pinning; Wrist function; PRWE; Gartland and Werley score.Abstract
Background and objectives: Common injuries that often call for surgery are displaced intra-articular distal radius fractures. Two common treatment methods are volar plate fixation and percutaneous k-wire. This study compared the clinical, functional, radiological, and postoperative results of open reduction and internal fixation using a volar plate with closed reduction with percutaneous K-wire fixation in adult patients with displaced intra-articular distal radius fractures.
Methods: A prospective, non-randomized comparative study was conducted between October 2025 and October 2026 in public and private hospitals in Erbil City, Iraq. Forty adult patients with displaced intra-articular distal radius fractures were included and allocated to either closed reduction with percutaneous K-wire fixation (n = 20) or open reduction and internal fixation using a volar plate (n = 20). Clinical, radiological, and functional outcomes were assessed.
Results: Baseline characteristics were comparable between the groups. Operative time was significantly shorter in the K-wire group than in the volar plate group (30 vs. 62 minutes, P = 0.001). The volar plate group demonstrated significantly greater flexion, extension, and supination at 6 weeks and 3 months (all P < 0.05), although these differences were no longer significant at 6 months. No significant differences were observed in postoperative radial height, volar tilt, radial inclination, overall radiological outcomes, Gartland and Werley scores, PRWE pain, PRWE function, or total PRWE scores. Postoperative complication rates were low and comparable between the groups.
Conclusion: Both volar plate fixation and percutaneous K-wire fixation provided satisfactory radiological and functional outcomes for displaced intra-articular distal radius fractures. Volar plate fixation facilitated faster early recovery of wrist motion, whereas K-wire fixation offered the advantage of a significantly shorter operative time.
