The Choice of Osteosynthesis for Distal Radius Fractures: A Matter of Taste, Fracture Instability, or Patient-Related Factors? A Retrospective Study of Functional Outcome in 346 Distal Radius Fractures Operated With Percutaneous Wires or Volar Plate Fixation.
Younger patients and those with more unstable fractures are more likely to receive volar plate fixation, but this choice does not lead to better functional outcomes compared to K-wire fixation.
Where it sits
this study against the rest of the ovagen (edl) corpusSummary and findings
This study examined the choice of surgical method for distal radius fractures (DRFs) in 346 patients, comparing percutaneous Kirschner wire (K-wire) fixation and volar locking plate (VLP) fixation. The study found no clinically significant differences in functional outcomes between the two surgical methods, regardless of fracture type. The choice of VLP was influenced by patient age and fracture instability.
Abstract
<h4>Background</h4>Surgery with volar locking plate (VLP) for distal radius fractures (DRFs) has become dominant over percutaneous Kirschner wire (K-wire) (PKW) fixation. Not many studies have proved advantages of the VLP and the increasing dominance of the VLP is thus not derived from evidence of superiority but influenced by other factors.<h4>Methods</h4>By retrospectively classifying 346 DRFs treated with either PKW or VLP fixation, according to the Buttazzoni classification system, we aimed to investigate the determining factors for choice of surgical method, and by review of the patients' medical records, the functional outcome, duration, and frequentness of the rehabilitation period were correlated to Buttazzoni type and surgical method.<h4>Results</h4>The odds ratio of having volar plate fixation was negatively correlated to age and positively correlated to a higher Buttazzoni type. We found no clinically significant differences in the functional outcome for different Buttazzoni type of fractures within the VLP and PKW groups, respectively, nor between the 2 methods of surgery for any Buttazzoni type of fracture.<h4>Conclusion</h4>Younger patients and fractures with higher grade of instability were more likely to be treated with VLP than PKW; however, neither fracture instability nor surgical method had any impact on functional outcome.