Title: Comparative Outcomes of Volar Locking Plate versus External Fixation in Complex Distal Radius Fractures: A Prospective Cohort Study
Authors: YACINE HAMID-ALLAH, OMAR ZIRRARI, HATIM ABID, MOHAMMED EL IDRISSI, ABDELMAJID EL MRINI
Volume: 10
Issue: 9
Pages: 51-55
Publication Date: 2026/09/28
Abstract:
Background & Methodology: Complex distal radius fractures (DRFs) remain a clinical challenge regarding optimal surgical stabilization. This prospective cohort study evaluated 120 adult patients with unstable complex distal radius fractures treated between January 2021 and December 2023. Patients were allocated into two surgical groups: Group A (n = 60) underwent Open Reduction and Internal Fixation with Volar Locking Plates (VLP), while Group B (n = 60) received Bridging External Fixation (EF) supplemented with percutaneous K-wires. Results: At the 12-month follow-up, Group A demonstrated significantly superior functional recovery, achieving lower QuickDASH scores (11.2 ± 3.4 vs. 19.8 ± 4.6; p < 0.001) and greater restoration of volar tilt (7.8° ± 2.1° vs. 3.2° ± 1.8°; p < 0.001). Surgical duration was longer in Group A (68.5 ± 11.2 min vs. 42.3 ± 8.7 min; p < 0.001), but length of hospital stay was comparable (1.8 ± 0.6 days vs. 1.6 ± 0.5 days; p = 0.082). Complication profiles differed markedly: Group A exhibited tendon irritation (6.7%), whereas Group B experienced high rates of pin-tract infection (18.3%) and CRPS (10.0%). Conclusion: Volar locking plates provide superior anatomical restoration, lower pain, and better long-term functional recovery compared to external fixation in intra-articular distal radius fractures.