Correction of volar tilt using the lift technique with fixed-angle volar locking plate in distal radius fractures.

OBJECTIVES

The aim of this study is to evaluate the radiological effectiveness of restoring volar tilt in dorsally displaced distal radius fractures using the lift technique performed with a fixedangle volar locking plate.

PATIENTS AND

METHODS

Between January 2023 and February 2025, a total of 14 patients (5 males, 9 females; median age: 46.9 years; range, 32 to 72 years) with dorsally displaced intraarticular or extra-articular distal radius fractures who underwent fixation with a fixed-angle volar plate using the visually estimated lift technique were retrospectively analyzed. Fractures were classified according to the AO classification. Pre-lift and post-lift volar tilt angles as well as plate-shaft angles were measured from fluoroscopy images, and control volar tilt angles were measured from radiographs. Actual angular correction was defined as the difference between pre-lift and post-lift volar tilt angles.

RESULTS

Fracture types were AO Type A in nine patients, AO Type C in four patients, and AO Type B in one patient. The median volar tilt angle at the time of fracture was -24.9° (range, -4° to -56°). Following traction and reduction maneuvers, the median pre-lift volar tilt was -4.9° (range, -20° to 4°), the median post-lift volar tilt was 9.5° (range, 0° to 15°), and the median volar tilt at follow-up was 9.4° (range, 1° to 16°). Plate-shaft angles ranged from 6° to 25° (median: 14.2°). Actual angular correction ranged from 5° to 25°. In 11 cases (78.5%), intraoperative correction achieved the target range of 5° to 15°. In three cases (15.4%), volar tilt correction was insufficient, with final values of 0°, 3°, and 4°. The ratio (R) of actual angular correction to theoretical angular correction was approximately 0.67.

CONCLUSION

The lift technique using a fixed-angle volar plate is a reliable and effective method for intraoperative correction of volar tilt in dorsally displaced distal radius fractures. The technique provides a valuable alternative, particularly in cases where manual reduction fails to achieve sufficient volar tilt restoration.