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Abstract

Background: Distal radius fractures (DRFs) are among the most common upper limb injuries, particularly affecting elderly osteoporotic individuals and young adults. Optimal surgical management for intra-articular DRFs remains debated, with volar locking plates and K-wire fixation being widely used techniques.
Objective: To compare the short-term functional outcomes of volar locking plate versus K-wire fixation in adult patients with intra-articular distal radius fractures.
Methods: This randomized controlled trial was conducted over six months at the Department of Orthopedics, Khyber Teaching Hospital, Peshawar. A total of 174 patients aged 30–65 years with distal radius fractures were enrolled and randomized into two equal groups. Group A (n=87) underwent volar locking plate fixation, and Group B (n=87) received percutaneous K-wire fixation. Patients were followed for six weeks, and functional outcomes were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) score. Data were analyzed using SPSS version 26, with significance set at p≤0.05.
Results: Group A showed significantly better functional outcomes, with 47.1% achieving excellent DASH scores compared to 31.0% in Group B. Poor outcomes were observed in 17.2% of patients in the K-wire group and none in the volar plate group. The mean DASH score was lower in the volar plate group (8.9 ± 4.7) versus the K-wire group (14.6 ± 6.2), indicating better function and recovery in the former.
Conclusion: Volar locking plate fixation demonstrated superior early functional outcomes compared to K-wire fixation. It may be the preferred option in cases requiring faster rehabilitation and better early recovery, although both methods remain clinically viable.