Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

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.

Correspondence should be addressed to David Bracey, Honorary Secretary c/o Royal Cornwall Hospitals Trust, Truro, Cornwall TR1 3LJ