What question did this study set out to answer?

The aim is to compare clinical and functional outcomes between Kirschner wire and volar locking plate fixation for distal radius fractures.

March 21, 2026Open Access

Comparison of Kirschner wire versus volar locking plate fixation for distal radius fractures: clinical and functional outcomes

Key Points

The aim is to compare clinical and functional outcomes between Kirschner wire and volar locking plate fixation for distal radius fractures.
Analyzed 201 patients with classified distal radius fractures (DRFs) from 2005 to 2022.
Treatment allocation based on fracture complexity and surgeon preference.
Functional outcomes assessed using validated measures at standardized intervals (6/12/24 months).
Older age, polytrauma, and complete articular fractures significantly influenced plate fixation choice.
Functional outcomes were comparable across all assessment metrics (P > 0.05).
Anatomical reduction quality was the primary determinant of functional success rather than fixation type.

Abstract

Objective: This study aimed to compare the clinical and functional outcomes of Kirschner wire (K-wire) fixation versus volar locking plate (VLP) fixation for intra-articular distal radius fractures (DRFs). It also aimed to identify key patient- and fracture-related factors that influence the choice of surgical technique and to evaluate the responsiveness of specific patient-reported outcome measures in assessing recovery. Methods: A total of 201 consecutive patients with Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association–classified DRFs (Type A: n = 51; B: n = 90; C: n = 60) treated surgically between 2005 and 2022 were analyzed. Treatment allocation was based on fracture complexity and surgeon preference, resulting in a distribution where K-wire (n = 63) was primarily used for partial articular fractures (72.4% of K-wire cases were Type B), while VLP (n = 138) was preferred for complete articular fractures (83.6% of plate cases were Type C). Functional outcomes were assessed using Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) (primary endpoint), Green-O’Brien, Gartland–Werley, and SF-12 at standardized intervals (6/12/24 months) during supervised physiotherapy. Results: Significant predictors of plate fixation included older age (58.1 ± 14.7 vs. 42.3 ± 12.1 years, P .05). K-wires represent a cost-effective alternative for partial articular fractures (72.4% of cases), while plates were more frequently used in complex fractures and polytrauma cases (adjusted odds ratio aOR = 2.4). Early rehabilitation (median 4 days post-op) and condition-specific metrics (QuickDASH, Green-O’Brien) are critical for optimal recovery, whereas SF-12 proves less sensitive for wrist-specific assessment. These findings advocate for surgeon-tailored technique selection based on fracture pattern and emphasize the need for multicenter randomized controlled trials (RCTs) to evaluate long-term outcomes. Cite this article as: Yigit O, Kart H, Cat G, et al. Comparison of Kirschner wire versus volar locking plate fixation for distal radius fractures: clinical and functional outcomes. Acta Orthop Traumatol Turc. 2026; 60(2), 0585, doi: 10.5152/j.aott.2026.25585.

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