RANDOMISED CONTROLLED TRIAL OF K-WIRE FIXATION VERSUS VOLAR LOCKING PLATE FIXATION IN THE TREATMENT OF UNSTABLE DISTAL RADIUS FRACTURES

Abstract

Purpose: This study compares clinical and radiological outcomes of K-wire fixation with volar locking plate (i.e. fixed angle) fixation in unstable, dorsally angulated, distal radius fractures.

Materials and methodology: Fifty four adult patients with an isolated, closed, unstable, dorsally angulated fracture without articular comminution were randomised to closed reduction and K-wire fixation (3 wires) or volar locking plate fixation. All were immobilised in a cast for six weeks and prescribed physiotherapy. Independent clinical and radiological assessment was performed at 3 and 6 months post injury, using the DASH and Gartland & Werley scoring systems.

Results: Twenty-four patients were treated with a plate and thirty with K-wires.

There were no complications in the plate group. There were 9 complications in the K-wire group. Three patients required re-operation (for malunion, median nerve compression, and retrieval of a migrated wire). Remaining complications included: 5 pin-site infections and 1 superficial radial nerve palsy.

Plate fixation achieved statistically significant better radiological and functional results.

Conclusion: Volar locking plate fixation achieves better radiological and functional results with fewer complications than K-wire fixation in unstable, dorsally angulated, distal radius fractures.