Evaluation of Functional Outcome of Extended Flexor Carpi Radialis Approach for Fracture Fixation of Distal End Radius Fracture.

INTRODUCTION

Intra-articular distal radius fractures require accurate anatomical reduction, articular congruity, and stable fixation to restore wrist function and preserve biomechanics. The extended flexor carpi radialis (eFCR) approach provides extensile exposure for complex fracture patterns.

MATERIAL AND

METHODS

This prospective observational study included 30 adults with closed intra-articular fractures treated by open reduction and internal fixation through the eFCR approach with volar locking plate fixation from April 2024 to June 2025. Functional outcome was assessed by disabilities of the arm, shoulder, and hand (DASH) score up to 6 months. Operative time, blood loss, range of motion, union, and complications were recorded.

RESULTS

Mean age was 45.83 ± 14.99 years. AO/OTA type C fractures accounted for 22 cases (73.3%) and type B for 8 cases (26.7%). Mean operative time was 89.23 ± 11.01 min and mean blood loss was 96.33 ± 11.89 mL. DASH score improved from 56.92 ± 8.98 at 2 weeks to 9.92 ± 4.20 at 6 months (P < 0.001). At 6 months, mean flexion, extension, supination, and pronation were 71.50 ± 2.70°, 60.10 ± 2.77°, 80.47 ± 4.31°, and 79.03 ± 3.94°. Volar tilt improved from -15.90 ± 3.48° to 9.81 ± 0.59°, radial inclination from 13.12 ± 2.24° to 24.74 ± 1.20°, radial length from 6.18 ± 1.25 mm to 12.06 ± 1.31 mm, and ulnar variance from +4.04 ± 1.07 mm to +0.65 ± 0.58 mm (all P < 0.001). Union occurred in all patients, with two minor complications.

CONCLUSION

The eFCR approach provided reliable anatomical restoration, satisfactory recovery of function, and low morbidity in closed intra-articular distal radius fractures at 6 months.