J Korean Fract Soc.  2008 Oct;21(4):325-333. 10.12671/jkfs.2008.21.4.325.

Volar Plating of Distal Radius Fractures

• Lee KH

• KMID: 1480924
• DOI: http://doi.org/10.12671/jkfs.2008.21.4.325

Abstract

Volar plating seems to indicate that many surgeons believe it leads to superior results, and is attractive because of the ease of the operative approach and the soft tissue sleeve to protect digital and wrist tendons. And also it have a locking mechanism to produce the fixed angle device with a low profile and may be thought to be a new era in the surgical treatment of dorsally displaced distal radius fractures even in the face of comminuted or osteoporotic bone. Locked volar plating allows direct fracture reduction, stable fixation and provides stability enough to allow early mobilization and function. The results with volar locking or fixed angle fixation for the general treatment of unstable distal radius fractures in elderly patients has been favorable. Volar plating has fewer complications than external fixation and dorsal plating and allow for earlier return to function. The current indications, technical aspects, clinical results, and complications of the volar plating are being reviewed.

Keyword

Distal radius fracture; Volar locking plate; Fixed angle plate

MeSH Terms

Aged
Early Ambulation
Humans
Radius
Radius Fractures
Tendons
Wrist

Figure

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  Fig. 1 Non-locking conventional volar plate for distal radius fractures.

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  Fig. 2 (A) The distal radius fracture was fixed with conventional plate, and the volar tilt was acceptable immediately after operation. (B) At 3 months follow-up, the union is advanced with collapsed dorsal cortex.

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  Fig. 3 Volar locking plate.

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  Fig. 4 Volar juxtaarticular locking plate, Synthes®.

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  Fig. 5 Combihole, Synthes®.

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  Fig. 6 The arrow indicates transverse ridge line of the distal radius.

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  Fig. 7 The plate is fixed distally, and the flexor tendon can be ruptured by attrition.

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  Fig. 8 This juxtaarticular plate is fixed distal to the transverse ridge.

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  Fig. 9 The pronator quadrates is elevated from the lateral edge of radial orign.

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  Fig. 10 A dotted line indicates transverse ridge, and the fracture site is exposed after elevation of pronator quadratus.

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  Fig. 11 (A) On anteroposterior view, plate and screws look like to violate the joint line. (B) But they don't violate the joint on tilt view. (C) At lateral view, it is not sure that the plate and scres involve the joint line. (D) It can be confirmed that they don't violate the joint at radial tilt lateral view.

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  Fig. 12 The pronator quadrates should be reattached its orign site.

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