External Fixation Vs Volar Locking Plate Fixation in Intra-Articular Distal Radius Fracture: A Prospective Randomized Comparative Study

Background: Intra-articular distal radius fractures are common injuries causing significant morbidity and impaired wrist function. Treatment options include external fixation and volar locking plate fixation. While plating allows anatomical reduction and early mobilization, controversy remains regarding optimal management. Our study compares functional and radiological outcomes of both methods to guide evidencebased surgical decision-making, particularly in resource-limited settings like India. Material and Methods: This prospective randomized study was conducted at a tertiary care hospital in Mumbai, India, over one year, 60 patients with closed intra-articular distal radius fractures (AO types B and C) were enrolled after obtaining informed consent. Patients were randomly allocated to two groups: Group A (n=30) underwent external fixation with closed reduction and K-wire supplementation if needed, while Group B (n=30) received volar locking plate fixation via the modified Henry's approach. Exclusion criteria included open fractures, bilateral injuries, and comorbidities affecting healing. Ethical approval was granted by the institutional review board. Follow-up assessments occurred at 3, 6, and 12 months postoperatively, evaluating functional outcomes using DASH and MAYO scores, range of motion with a goniometer, grip strength via dynamometer, and radiological parameters (volar tilt, radial height, ulnar variance) on X-rays. Data analysis employed SPSS software, with Student's t-test for continuous variables and chi-square for categorical data; p