Comparison between Volar Locking Plate and Kirschner Wire Fixation for Unstable Distal Radius Fracture: A...

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Evidence-Based Medicine

Background:

• Unstable distal radius fractures require surgical intervention.
• Comparing fixation methods is crucial for optimal patient outcomes.

Purpose of the Study:

• To compare volar locking plating (VLP) versus percutaneous Kirschner wires (K-wire) for unstable distal radius fractures.
• To evaluate functional and radiographic outcomes, and complication rates.

Main Methods:

• Systematic search of RCTs in MEDLINE, EMBASE, Cochrane Central until January 2022.
• Meta-analysis of DASH scores, PRWE scores, grip strength, range of motion, and complications.
• Random effects models used for analysis, results presented as RR or MD with 95% CI.

Main Results:

• VLP fixation showed significantly better DASH scores at all follow-up points (6 weeks to 12 months).
• VLP demonstrated superior grip strength and PRWE scores at 3 months, with early range of motion advantages.
• Superficial infections were more frequent with K-wire fixation; radiographic outcomes were similar except for volar tilt favoring VLP.

Conclusions:

• Both VLP and K-wire fixation are effective for unstable distal radius fractures.
• While VLP offers some functional and radiographic benefits, evidence for superiority is limited.
• Observed differences in outcomes are small and may not be clinically noticeable to patients.