Palmar Z-Osteotomy for Distal Radius Fractures.

Background

Distal radius fractures (DRFs) are a common injury with fracture parameters guiding surgical treatment. Palmar plating is the most common method of fixation in patients needing surgical fixation. However, in fractures with a complete or nearly intact volar cortex, reduction of the fracture fragments may be challenging with the palmar approach. We use a novel Z-osteotomy technique to address this issue and report on our outcomes.

Methods

This is a retrospective review of all patients where a volar Z-osteotomy technique was used. We assessed pre-, intra- and postoperative radiographic parameters, fracture union and final wrist range of motion of all patients.

Results

Twelve DRFs in 11 patients were analysed. All fractures were successfully plated palmarly with volar tilt 9-14 (average: 11.3) and all achieved fracture union. This was maintained in the final radiographs with good clinical wrist range of motion.

Conclusions

The volar Z-osteotomy technique described allows surgeons to achieve anatomical reduction of volar tilt in DRFs where the volar cortex is intact with good clinical and radiological outcomes. Level of Evidence: Level IV (Therapeutic).