Eyüp ŞENOCAK, Muhammet ÇELİK, İbrahim DAĞ, Bilal KARABAK, Kamber KAŞALİ
Archives of Basic and Clinical Research - 2026;8(2):206-211
Objective: To comparatively evaluate the clinical, functional, radiological, and cost related outcomes of Kirschner wire fixation versus volar locking plate osteosynthesis in the management of intra-articular distal radius fractures. Methods: A retrospective comparative study was conducted in 133 patients who had Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association type C distal radius fractures and who underwent surgical treatment between 2017 and 2023. Patients were allocated to two groups based on fixation technique: Kirschner wire fixation (n=67) and volar locking plate fixation (n=66). Functional outcomes were assessed using the disabilities of the arm, shoulder and hand (DASH) questionnaire and the Mayo Wrist Score at the 1st, 3rd, and 6th postoperative months. Additionally, Wrist range of motion, perioperative variables, and total treatment costs were analyzed. Longitudinal and intergroup comparisons were performed to determine temporal recovery patterns and treatment-related differences. Results: Kirschner wire fixation was associated with significantly shorter operative duration, reduced intraoperative blood loss, shorter hospitalization, and substantially lower overall treatment cost compared with volar plating (all P < 0.001). Conversely, patients treated with volar plate osteosynthesis demonstrated significantly superior functional recovery and greater wrist range of motion during the early postoperative period (P < 0.001). Although both groups exhibited progressive and significant improvement over time (P < 0.001), intergroup differences diminished by the sixth postoperative month. Notably, DASH scores at 6 months indicated slightly better patient-reported outcomes, suggesting comparable mid-term patient-reported functional outcomes with the less invasive technique despite inferior early recovery. Conclusion: Volar locking plate fixation provides enhanced early postoperative functional recovery and wrist mobility in intra-articular distal radius fractures. However, Kirschner wire fixation remains a cost-effective and surgically efficient alternative with comparable mid-term clinical outcomes. These findings support an individualized treatment strategy based on fracture characteristics, patient expectations, surgeon experience, and healthcare resource considerations.
