Year: 2024 | Month: January | Volume: 11 | Issue: 1 | Pages: 372-382
DOI: https://doi.org/10.52403/ijrr.20240142
Functional Outcome and Range of Motion Between Internal Plate Fixation Versus Kirschner Wire for Management of Distal Radius Fracture: A Meta-Analysis
Adiet Wahyu Kristian1, Anak Agung Gde Yuda Asmara2
1Resident of Orthopaedics and Traumatology Department,2Consultant of Orthopaedics and Traumatology Department,
General Hospital Prof. IGNG Ngoerah, Faculty of Medicine Udayana University, Bali, Indonesia.
Corresponding Author: Adiet Wahyu Kristian
ABSTRACT
Introduction: A significant percentage of fractures treated in clinical practice are distal radius fractures, which are among the most common orthopaedics injuries. Distal radius fractures are common and can affect wrist function and general quality of life, thus they need to be addressed carefully. This research aims to assess the evidence supporting VLP and K-wire fixation procedures in the treatment of distal radius fractures.
Methods: According to PRISMA guideline statement, the research was conducted. A systematic search was conducted in past 10 years. This research will include English-language, randomized, controlled studies that compare VLP with K-wire fixation for the management of distal radius fracture and have full-text. Data collection included functional outcome measures, specifically the Disabilities of the Arm, Shoulder, and Hand (DASH), wrist Range of Motion, and clinical complication, which have been recommended as the best available patient-reported outcome measurement instruments for distal radius fractures.
Result: The plate group had a higher DASH score with a difference of 1.46 but this result was not statistically significant (95% CI=3.09-(-0.16), p=0.08). Based on grip strength, it was found that the grip strength was greater in the wire group although there was no statistically significant difference (2.28; 95%CI=-0.13-4.70, p=0.06). There were fewer complications when using the plate with an Odd Ratio of 0.31 (95% CI=0.22-0.43, p<0.00001).
Discussion: Plate fixation is still valuable because of its stability, brief period of immobility, and rapid return to an active life. The usage of locking plate fixations in the treatment of distal radius fractures has increased recently. Anatomical repair of the articular surface and fragment alignment promotes functional rehabilitation and delays the onset of osteoarthritis. K-wires are commonly used because they are easy to implant, don't injure tissue much, have an atraumatic insertion, and result in less stiffness and edema. Two other advantages are reduced risk of infection and enhanced fracture healing. Their disadvantages include wire migration, peripheral neurovascular injury, and less firm fixation. There was no difference between the two groups DASH scores or grip strengths according to the forest plot results. After a year, the study of wrist range of motion revealed no appreciable variations in flexion, extension, or pronation. It was discovered that treating distal radius fractures with plates had fewer difficulties than treating them with wires, based on the patient's issues.
Keywords: Distal Radius Fracture, Fracture, Kirschner Wire, Plate Screw.
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