Volar plating of dorsally comminuted fractures of the distal radius: a 6-year study

This article describes a 6-year study of use of volar plating in treating unstable dorsally comminuted distal radius fractures. Forty-six fractures treated with volar plating were reviewed. All cases were followed for at least 6 months; 35 were followed for more than 1 year. Fractures treated with adjunctive protruding pins were excluded. Bone graft was used in 4 cases. Anatomical results were rated excellent or good in 39 cases (85%). Subsidence occurred in 9 fractures, 4 of which malunited. Flexor pollicis longus tendon attrition occurred in 2 cases. Mean operative time was less than 1 hour (range, 30-90 minutes). Study results support continued use of volar plating in treating selected unstable dorsally displaced fractures of the distal radius. Prominent plates and sharp-edged screws may imperil deep flexor tendons and should be removed. More liberal use of bone graft and improvements in plate design should reduce complications.