Outcomes of spring wire fixation for distal radius fractures with associated volar rim fragment: A systematic review

The fractures of distal end radius, especially with an intraarticular component are common even in the developed world. Recently the advent of fragment specific anatomic plates for the distal radius have emerged as the implant of choice for these fractures. Despite the choices available for treating distal radius fractures, it is practically difficult to stabilize marginal volar fragments. In such situations, the k-wires with narrow diameter can be used as a spring wire in addition to plate to stabilize the fragment. In this article we tried to systematically review the outcomes of spring wire technique in volar marginal fragments of distal end radius fractures.

The registration ID of this study in PROSPERO is CRD4202613008653. The studies which described various treatment methods of fractures of distal radius with rim fragment on volar side using spring wires (K-wires) to stabilize the volar rim fragment were included. Outcomes such as change in grip strength, improvement in range of movements (ROM) and complications like loss of reduction, nerve injury, tendon injury, implant removal were recorded.

The PRISMA methodology was followed to arrive at the selected studies. Among six included studies, four were retrospective studies and only one was prospective study. All the studies had a quality score of more than 9/14 and were subsequently included in the analysis. The review included a total of 56 patients. All the studies showed good outcomes after the spring wire technique. The movements at the wrist joint were reported by all the studies and grip strength was reported by two studies.

The spring wire technique is reliable and a low-cost measure to take care of the volar rim fragments. Though there are no studies reporting formal cost-analysis of this technique, the K-wires are readily available in all the setups which make this an attractive option.