{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:32:44Z","timestamp":1789590764979,"version":"build-2803163510"},"reference-count":49,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003This study aims to compare the outcomes of volar locking plating (VLP) versus percutaneous Kirschner wires (K-wire) fixation for surgical management of unstable distal radius fractures.<\/jats:p><jats:p>\n          Methods\u2003We systematically searched multiple databases, including MEDLINE, EMBASE, Cochrane Central till January 2022 for randomized controlled trials (RCTs) that met eligibility criteria. Following outcomes were evaluated at 6-week, 3-, 6-, and 12-month follow-up period: Disabilities of the Arm, Shoulder, and Hand (DASH) score, Patient Rated Wrist Evaluation (PRWE) score, grip strength, range of motion, and complication incidence. Meta-analysis was performed using random effects models and results presented as risk ratios (RRs) or mean differences (MDs) with 95% confidence interval.<\/jats:p><jats:p>\n          Results\u2003Fourteen RCTs with 1,450 participants met the inclusion criteria. DASH scores were significantly better for VLP fixation at 6th week (MD\u2009=\u200919.02; p\u2009&lt;\u20090.001), 3rd (MD\u2009=\u200910.79; p\u2009&lt;\u20090.001), 6th (MD= 7.78; p\u2009&lt;\u20090.001), and 12th month (MD\u2009=\u20092.94; p\u2009&lt;\u20090.001) postoperation. At 3-month follow-up period, VLP treatment exhibited better grip strength (MD\u2009=\u2009\u2212\u200910.32; p\u2009&lt;\u20090.001) and PRWE scores (MD\u2009=\u20098.78; p\u2009&lt;\u20090.001). There was a statistically significant early advantage in flexion, extension, pronation, supination, radial deviation, and ulnar deviation in the VLP group at 6-week follow-up, but at 1-year follow-up only significantly better extension was observed. At 1 year, radiographic outcomes were similar except for volar tilt favoring VLP fixation (p\u2009&lt;\u20090.001). Superficial infections were more common in patients treated with K-wire (RR\u2009=\u20092.89; p\u2009=\u20090.001), but there was no difference in total complications or reoperation rates (p\u2009&gt;\u20090.05).<\/jats:p><jats:p>\n          Conclusion\u2003This meta-analysis suggests that VLP fixation and K-wire fixation are both effective procedures, but existing literature does not provide sufficient evidence to demonstrate the superiority of either method. Although VLP fixation improves DASH score, extension and volar tilt at 12-month follow-up, the difference is small and unlikely to be noticeable to the patients.<\/jats:p>","DOI":"10.1055\/s-0043-1768235","type":"journal-article","created":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T00:04:55Z","timestamp":1681517095000},"page":"469-480","source":"Crossref","is-referenced-by-count":7,"title":["Comparison between Volar Locking Plate and Kirschner Wire Fixation for Unstable Distal Radius Fracture: A Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1108-0731","authenticated-orcid":false,"given":"Muhammad A.","family":"Tariq","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzair","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qazi S.","family":"Uddin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dow Medical College, Dow University of Health Sciences Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahabia","family":"Altaf","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dow Medical College, Dow University of Health Sciences Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashar","family":"Mohiuddin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,4,14]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.4103\/2249-4863.148101","article-title":"Fractures of distal radius: an overview","volume":"3","author":"S Meena","year":"2014","journal-title":"J Family Med Prim Care"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1186\/s12891-021-04128-5","article-title":"Epidemiology of distal radius fractures in children and adults during the COVID-19 pandemic - 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Experimento cl\u00ednico de distribuci\u00f3n aleatoria y controlado","volume":"31","author":"J Manrique","year":"2017","journal-title":"Rev Colomb Ortop Traumatol"},{"issue":"01","key":"ref34","doi-asserted-by":"crossref","first-page":"e187053","DOI":"10.1001\/jamanetworkopen.2018.7053","article-title":"Assessment of distal radius fracture complications among adults 60 years or older: a secondary analysis of the WRIST randomized clinical trial","volume":"2","author":"K C Chung","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"01","key":"ref35","first-page":"107","article-title":"Functional outcome with Kirschner wire fixation versus volar locking plate fixation for management of patients with dorsally displaced fractures of distal radius","volume":"45","author":"N U Khan","year":"2020","journal-title":"Rawal Med J"},{"issue":"05","key":"ref36","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.cjtee.2021.04.005","article-title":"A comparative study of variable 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(SDQ), and Western Ontario Shoulder Instability Index (WOSI)","volume":"63","author":"F Angst","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"08","key":"ref39","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1007\/s11999-014-3666-y","article-title":"What is the minimum clinically important difference in grip strength?","volume":"472","author":"J K Kim","year":"2014","journal-title":"Clin Orthop Relat Res"},{"issue":"11","key":"ref40","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1177\/0284185119834687","article-title":"Distal radius fractures and radiographic assessment: a systematic review of measurement accuracy","volume":"60","author":"J Jensen","year":"2019","journal-title":"Acta Radiol"},{"issue":"03","key":"ref41","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1302\/0301-620X.99B3.35819","article-title":"Do radiological and functional outcomes correlate for fractures of the distal radius?","volume":"99-B","author":"C E Plant","year":"2017","journal-title":"Bone Joint J"},{"issue":"01","key":"ref42","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s11552-007-9063-1","article-title":"Biomechanical evaluation of volar locking plates for distal radius fractures","volume":"3","author":"S M Levin","year":"2008","journal-title":"Hand (N Y)"},{"issue":"02","key":"ref43","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s11552-007-9074-y","article-title":"Biomechanical comparison of different volar fracture fixation plates for distal radius fractures","volume":"3","author":"K Sobky","year":"2008","journal-title":"Hand (N Y)"},{"issue":"02","key":"ref44","first-page":"102","article-title":"Early rehabilitation of distal radius fractures stabilized by volar locking plate: a prospective randomized pilot study","volume":"6","author":"S Quadlbauer","year":"2017","journal-title":"J Wrist Surg"},{"issue":"19","key":"ref45","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.2106\/JBJS.M.00860","article-title":"Accelerated rehabilitation compared with a standard protocol after distal radial fractures treated with volar open reduction and internal fixation: a prospective, randomized, controlled study","volume":"96","author":"J L Brehmer","year":"2014","journal-title":"J Bone Joint Surg Am"},{"issue":"08","key":"ref46","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1302\/0301-620X.97B8.35234","article-title":"Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius: analysis from the DRAFFT trial","volume":"97-B","author":"S Tubeuf","year":"2015","journal-title":"Bone Joint J"},{"issue":"10","key":"ref47","doi-asserted-by":"crossref","first-page":"e0240377","DOI":"10.1371\/journal.pone.0240377","article-title":"Volar locking plate versus 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