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Comparison of volar plate screw fixation with k-wire fixation by closed technique in instable distal radius fractures

Ismail Guzel, Serkan Akpancar.




Abstract

The aim of the present study was to compare the clinical outcomes of volar plate screw fixation with the K-wire fixation with external fixator applied with closed technique in instable distal radius fractures extending to the joint in elderly patients. The study included 60 patients who were treated for AO type C distal radius fracture in our clinic between January 2016 and January 2019. The patients were divided into two groups: Group External fixator (EF) with 30 patients who underwent multiple K-wires using closed technique and Group Volar Plate (VP) with 30 patients who underwent volar plate and screw fixation using open technique. Wrist range of motion (ROM), disabilities of the arm, shoulder and hand (DASH) score and grip strength values, radiologic parameters were compared between groups. After 12 months of follow-up, there was no significant difference in DASH score and grip strength values between the two groups (p = 0.263 and 0.085, respectively). The mean duration of surgery was found to be shorter in the EF group (p < 0.001). There was no significant difference between radiologic parameters. Significantly fewer fluoroscopy applications were needed in the VP group than in the EF group (p < 0.001). Both VP and EF treatments had similar functional outcomes in patients over 65 years of age. Considering its shorter duration of surgery and less invasive nature, EF treatment was concluded to be more applicable in patients over 65 years of age.

Key words: Radius, Fracture, plate, screw, fixation






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