Low-profile dorsal plating for dorsally angulated distal radius fractures

Dorsal plating emerged as an effective treatment for dorsally displaced distal radius fractures in the late 1980s. In addition to some mechanical advantages, this method provided a clear view of the articular surface and the ability to restore the anatomy. However, because of the frequent occurrence of extensor tendon complications in the early designs of dorsal plates, the volar approach gained favor for repairing these types of fractures. Recent improvements in dorsal plating designs have yielded increasingly thinner, precontoured plates with rounded edges and low-profile flush screw heads. These new plates have shown decreased rates of extensor tendon complications while retaining the advantages of the original dorsal approach. The authors have used this technique in more than 70 cases during a 4-year period. This article will review the history, indications, contraindications, technique, and rehabilitation for dorsal plating of dorsally angulated distal radius fractures.