PERCUTANEOUS K-WIRING VERSUS CONSERVATIVE TREATMENT FOR DISPLACED DISTAL RADIAL FRACTURES IN ADULTS

Abstract

DRFs or distal radius fractures are the most common orthopedic injury with an estimated 17 percent of all adult fractures. The trauma of such fractures is usually caused by the fall on the open hand, which causes dislocation to an extent and instability. Although conservative techniques, like closed reduction and casting, are widely used, the risk of misalignment in the course of healing brings the issue of functional disability in the long-term. On the contrary, less invasive surgical procedures that have found popularity in recent times are percutaneous K-wire fixation that involves preserving anatomical positioning and reducing complications. The best treatment of displaced distal radius fractures, especially extra-articular fracture (AO Type A) is however controversial. The purpose of this study is to compare the functional results of percutaneous K-wire fixation and conservative care in terms of Disability of Arm, Shoulder, and Hand (DASH) score which is a well-known instrument of measuring the upper limb functionality. The trial was a randomized controlled trial (RCT) that was done at Abbasi Shaheed Hospital in Karachi, and involved 80 adult patients with displaced distal radius fractures. The subjects were distributed at random to either the K-wire fixation group or the conservative treatment group. This paper reported that there were an important difference in functional outcomes, with the K-wire fixation group making lower scores on DASH than the conservative treatment group, which is contrary to the expectation considering the previous research. These results were due to factors like fracture type, timing of treatment and severity of the fracture. This study offers fresh information on the comparative efficacy of both treatment modalities and highlights the significance of fracture features in perceiving the results of treatments. The present results can be discussed as the continuation of the debate on the most effective management approaches to displaced distal radius fracture and indicate that conservative management can be a potentially better option in terms of functional recovery of some fracture variants