title: Comparison of distal radius fracture intra-articular step reduction with volar locking plates and K wires: a retrospective review of quality and maintenance of fracture reduction.
abstract: This study investigated the accuracy and maintenance of reduction of intra-articular steps achieved with closed reduction and percutaneous K wires and open reduction and a volar locking plate for the treatment of intra-articular distal radius fractures. We performed a retrospective review of 359 patients with an intra-articular fracture of their distal radius. Multivariate linear regression was undertaken to investigate the influence of multiple variables such as age, gender, initial displacement and treatment method on reduction despite differences between groups. A total of 36% of patients treated with K wires and 29% with volar locking plate had a step greater than or equal to 1 mm present on the first post-operative radiograph. A total of 23% treated with K wires and 28% with volar locking plate had a residual step of 1 mm or more on the last available radiograph. There was no difference identified between the two techniques for quality of initial reduction or persisting step on the last available radiographs. Step behaviour and further reduction of step post-operatively was similar for both treatment methods. Initial displacement and increased age influenced initial reduction. Initial fracture displacement shown radiologically was the only variable identified that influenced the persistence of a step on post-operative radiographs.
  
  
  METHODS
  IV.
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, UK.
authors.forename: N A
authors.initials: NA
authors.lastname: Johnson
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Dias
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Wildin
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, UK.
authors.forename: L
authors.initials: L
authors.lastname: Cutler
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, UK.
authors.forename: B
authors.initials: B
authors.lastname: Bhowal
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, UK.
authors.forename: A S
authors.initials: AS
authors.lastname: Ullah
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001864:Bone Wires; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Distal radius fracture; Kirschner wires; volar locking plate; wrist fracture