Vol. 11, Issue 4 (2025)

Background: Distal radius fractures are common injuries, particularly in middle-aged and elderly populations. While Volar Locking Plate (VLP) fixation has improved outcomes, concerns remain regarding secondary displacement in comminuted or osteoporotic fractures. Supplementary Kirschner wire (K-wire) fixation has been proposed to enhance metaphyseal stability and maintain reduction.
Aim of the study: To evaluate the clinical, radiographic, and functional outcomes of distal radius fractures managed by open reduction and internal fixation (ORIF) using volar locking plate augmented with supplementary K-wire fixation.
Methods: This prospective observational study included 75 patients with displaced distal radius fractures requiring surgical fixation, conducted at the Department of Orthopedic, Shaheed Tazuddin Ahamed Medical College, Gazipur, Bangladesh between January 2024 and December 2024. Patients were treated with ORIF using a volar locking plate, with supplementary K-wire augmentation as needed. Radiographic parameters (radial height, inclination, volar tilt, articular step-off) and functional outcomes (Mayo Wrist Score, DASH score, grip strength, range of motion) were assessed at 6 weeks, 3 months, 6 months, and 12 months. Complications were documented, and radiographic quality of reduction was graded according to Sarmiento criteria.
Results: The mean patient age was 46.2±12.8 years, with a slight male predominance (56%). Postoperative radiographs demonstrated significant improvements in radial height, inclination, and volar tilt, largely maintained at 12 months (p<0.01). Articular step-off > 2 mm decreased from 10.7% preoperatively to 1.3% at final follow-up. Functional outcomes improved significantly over 12 months, with mean Mayo Wrist Score reaching 89.1±6.0 and DASH score decreasing to 11.6±5.4 (p<0.001). Grip strength recovered to 93.4% of the contralateral side. Excellent or good reduction quality was achieved in 93.3% of cases. No tendon irritation or rupture was observed.
Conclusion: ORIF using volar locking plates augmented with supplementary K-wires provides stable fracture fixation, excellent radiographic alignment, and favorable functional recovery in distal radius fractures, without increasing complication risk. This approach is particularly beneficial for fractures with metaphyseal comminution or instability.