# 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.

## Key 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.