Introduction: Orthopaedic practice frequently deals with Distal Radius Fractures (DRFs); however, the treatment strategies for optimal functional outcomes remain uncertain. K-wiring (Kirschner Wire) is a minimally invasive technique preferred for simple fractures, whereas Fragment-Specific Plating (FSP) offers targeted fixation for complex fracture patterns. Aim: To compare the functional and radiological outcomes of DRFs managed with K-wiring versus FSP. Materials and Methods: The present prospective interventional study was performed in the Department of Orthopaedics of a tertiary care hospital at Pune, Maharashtra, India, over 24 months from January 2023 to December 2024. A total of 40 patients were randomly categorised: K-wire group (n=20) and Plate group (n=20). Functional outcome was assessed with the Mayo modified wrist score, while radiological outcomes included radial inclination, radial height, and volar tilt. The patients were followed-up at 3, 6, and 12 months. Results: At three and six months, significantly greater proportion of patients in the Plate group had higher range of motion (p=0.003 and 0.029, respectively), and total scores (p=0.017 and 0.039, respectively). Similarly, at 6 and 12 months, patients in the Plate group had higher grip strength scores (p=0.025 and 0.010, respectively). Moreover, at three and 12 months, patients in the plate group had higher satisfaction (p=0.003) and higher pain scores (p=0.028), respectively. Both the groups had comparable radial inclination at all the intervals (p>0.05) and volar tilt at three months (p=0.116). At three months, the mean radial height was significantly greater in the plate group (p=0.012). Furthermore, at six and 12 months, the plate group demonstrated significantly higher radial height (p=0.003 and <0.001, respectively) and volar tilt (both p<0.001) compared to the K-wire group. However, the K-wire group was associated with significantly reduced operative time and shorter duration of hospital stay (both p<0.001). Conclusion: Both K-wiring and FSP are effective surgical methods for managing DRFs. However, FSP provides significantly better functional and radiological outcomes, and should be preferred, particularly in patients with complex DRFs.
Jawa et al. (Wed,) studied this question.