Outcome of Extra-articular Distal End Radius Fractures: K-wire Fixation or Cast Immobilization?

Abstract Introduction: Distal radius fractures are a common orthopedic injury often managed through either surgical or conservative methods, primarily K-wire fixation or cast immobilization. Each method presents unique benefits and limitations. While K-wire fixation provides stability and preserves fracture alignment, cast immobilization is less invasive. The study investigates the outcomes of extra-articular distal radius fractures treated with either K-wire fixation or cast immobilization to provide data for evidence-based management. Materials and Methods: This prospective cohort study included 102 adult patients with acute, closed, extra-articular distal radius fractures, randomized into two treatment groups. Group I underwent K-wire fixation, whereas Group II received cast immobilization. Both groups followed a standardized rehabilitation protocol. Outcomes were assessed through functional (DASH score and range of motion [ROM]) and radiological parameters (radial length, inclination, and volar tilt), with regular follow-ups over 6 months. Results: Both groups showed satisfactory initial alignment and reduction. At 6 weeks, Group I exhibited superior radiological outcomes, with better maintenance of radial length, inclination, and volar tilt compared to Group II. Functional assessments at 6 months revealed no significant difference in DASH scores, though Group I demonstrated improved ROM, particularly in flexion, extension, and ulnar deviation. Complication rates were minimal and comparable between groups. Conclusion: Both K-wire fixation and cast immobilization are effective for managing extra-articular distal radius fractures. However, K-wire fixation may offer advantages in maintaining fracture reduction and enhancing ROM. Individualized treatment decisions should consider patient and fracture characteristics.