In this single-center retrospective study, ORIF-TKW was associated with superior peri-operative outcomes, earlier radiographic union, and a less invasive planned removal procedure compared with ORIF-P, while functional recovery was similar. A post-hoc analysis demonstrated statistical comparability in fracture complexity within the 2B subgroup, partially mitigating concerns regarding selection bias. However, these findings remain hypothesis-generating and subject to residual confounding; prospective randomized trials with stratification based on fracture morphology are required before any change in routine practice can be recommended. The limited revision experience (2 cases) is insufficient to endorse threaded K-wire fixation as a routine salvage strategy.
Zhang et al. (2026) studied this question.