[The volar locking plate for extension fractures of the distal radius].

OBJECTIVE

Bony healing of dislocated distal radius fractures after open reduction and internal stabilization by locking screws/pins using palmar approach.

INDICATIONS: Extraarticular distal radius fractures type A2/A3, simple extra- and intraarticular fractures type C1 according to the AO classification, provided a palmar approach is possible.

CONTRAINDICATIONS: Forearm soft tissue lesions/infections. As a single procedure if a volar approach not possible.

SURGICAL TECHNIQUE: Palmar approach to the distal radius and fracture. Open reduction. Palmar fixation of the plate to radial shaft with single screw. After fluoroscopy, distal fragments fixed using locking screws.

POSTOPERATIVE MANAGEMENT: Below-the-elbow cast for 2 weeks. Early exercise of thumb and fingers, wrist mobilization after cast removal. Complete healing after 6-8 weeks.

RESULTS

Ten patients averaged 100% range of motion of the unaffected side after 43±21 months. No complications observed. DASH score averaged 12±16 points; Krimmer wrist score was excellent in 7, good in 2, and fair in one.