Functional Outcomes of Intra-articular Distal Radius Fractures: Single-Incision Three-Column Fixation Using Volar Locking Plate and K-Wire Stabilization

TL;DR

This study shows that a modified surgical method using a volar plate and K-wires improves wrist function and recovery for complex distal radius fractures.

Contribution

A modified surgical technique for intra-articular distal radius fractures using a single volar approach with three-column fixation is evaluated.

Findings

QuickDASH scores improved significantly from 67.8 at one month to 8.07 at six months.

Wrist range of motion showed marked improvement across all parameters.

Radiographic stability was maintained with no changes in volar tilt, radial inclination, or ulnar variance.

Abstract

Background: Distal radius fractures are common, accounting for 17% of all fractures and 75% of forearm fractures. Their age distribution is bimodal, affecting younger individuals with high-energy trauma and older adults with osteoporotic bones. Efficient management is essential to prevent long-term complications such as malunion and chronic discomfort. This study aims to evaluate the clinical and functional outcomes of intra-articular distal radius fractures treated with a modified surgical procedure using a 2.7-mm locking volar plate and K-wires for three-column fixation via a single volar approach.

Methods: This prospective interventional study was conducted at a tertiary care institute from January 2019 to August 2020. Patients with closed or open (Gustilo Anderson Type I) intra-articular distal radius fractures classified as AO Types B and C were included. Exclusion criteria were complex fractures (Type II or III), pathological fractures, or significant comorbidities. Thirty-five patients underwent treatment with volar plating, with or without K-wire fixation, and were subsequently monitored for clinical and functional outcomes using QuickDASH ratings and range of motion assessments. Radiographic evaluations were performed to assess fracture alignment and healing.

Results: The study included 24 males and 11 females, with a mean age of 35.2 years. QuickDASH scores improved significantly, from 67.8 at one month to 8.07 at six months (p < 0.00001). Wrist range of motion also showed marked improvement across all parameters. Radiographic findings remained stable during follow-up, with no changes in volar tilt, radial inclination, or ulnar variance. Complications were minimal, with three patients developing wrist stiffness and one patient experiencing a postoperative infection.

Conclusion: The modified surgical technique using a 2.7-mm locking volar plate and K-wires for three-column fixation offers efficient stabilization and functional recovery in intra-articular distal radius fractures. This method offers significant improvements in wrist function while maintaining consistent radiographic outcomes, supporting its use in the management of complex fractures.

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