Anterior Approach and Volar T-plate fixation of Distal Radius Fracture

Abstract

Purpose: To analyze the radiologic and clinical results of open reduction and volar plating through anterior approach for distal radius fracture. Materials and Methods: We retrospectively analysed that 19 distal radius fracture, which would not be reduced by closed reduction or too comminuted to maintain reduction or articular surface incongruency, were treated by open reduction and volar plating through anterior approach. The results were evaluated by preoperative and immediate postoperative radiographics and clinical results were analysed using Green and O'Brien scoring system at final follow up. Results: All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (8.8 mm ± 4.8 mm vs. 11 mm ± 3 mm), radial inclination (15 °± 5.7 ° vs. 20 °± 5 ° ), volar tilt (-11 °± 13 ° vs. 7 °± 4 ° ) and ulnar plus variant (4 mm ± 3 mm vs. 0 mm ± 1 mm) were improved. The clinical evaluation revealed 9 excellent cases, 7 good cases, 2 fair cases and 1 poor case. The reduction loss and flexor pollicis longus rupture was occurred in one patient, who had severely displaced comminute fracture in initial injury. Conclusion: Using volar plating, authors gain good radiologic and clinical results. But, additional external fixation is recommended to prevent further collapse in severly comminuted fractures.