FUNCTIONAL OUTCOME OF UNSTABLE DISTAL RADIUS INTRA ARTICULAR FRACTURE TREATED WITH K-WIRES SUPPORTED EXTERNAL FIXATOR VERSUS VOLAR LOCKING PLATE

Abstract

OBJECTIVE:To compare the functional outcome of external fixator with K-wires versus volar locking plate in patients with unstable distal radius intra-articular fracture.

MATERIALS AND METHODS:Study was Randomized controlled trial in department of Orthopedic Surgery, KEMU/ Affiliated Hospital, Lahore in duration ofSix months. Sample size was 210 cases (105) in each group. It is calculated by using 95%of confidence level, 80% power of rest and taking expected good outcome 46.6%in external fixator and 30% in volar locking.Non probability consecutive sampling was used. Study included both gender of age 18-40 years and Patients with unstable distal radius intra-articular fracture. Data was analyzed by SPSS version 25.0. Post stratification chi-square test was applied to see their effects taking p value < 0.05 as significant.

RESULTS:A comparative analysis involving 210 patients (105 per group) treated for unstable intra-articular distal radius fractures demonstrated equivalent clinical and radiographic outcomes between those managed with external fixation. There were no statistically significant differences observed in functional outcome measures, including DASH and PRWE scores, grip strength, radiographic parameters such as radial height, volar tilt, and articular step-off, or patient-reported outcomes related to pain and satisfaction. Group A exhibited a marginally earlier time to radiographic union and weight-bearing initiation. Complication rates remained low and were comparable between the two groups. Based on proforma-guided evaluation, excellent functional outcomes were achieved in 78.1% of patients in Group A and 81.0% in Group B. These findings suggest that both surgical techniques are effective, with neither demonstrating definitive superiority over the other.

CONCLUSION:Both external fixation with K-wires and volar locking plates are viable treatment options for unstable distal radius intra-articular fractures. While there are minor differences in time to healing and radiographic parameters, neither technique demonstrates clear superiority over the other. The choice of treatment should be guided by patient-specific factors, surgeon experience, and local resources.

KEYWORDS:Unstable distal radius, Intra articular fracture, K-Wires, External fixator, Volar locking plate.