[Comparison of two approaches for the treatment of distal radius fractures]

To discuss the effective operative approach for the treatment of distal radius fractures.

From March 2003 to April 2010,107 patients with distal radius fractures suffered internal fixation with locking compression plate (LCP). There were 48 males and 59 females with an average age of 51.27 years (ranged, 23 to 79). Of them, with directed volar approach was in 55 cases and Henry approach was in 52 cases. Surgical feature, fractured exposure time, operative time, median nerve complication, repair rate of the musculus pronator quadratus were compared between the two groups. Gartland-Werley wrist score (GW score), range of motion of wrist joint, grasp force and imageology score were observed in two groups at the first year after operation.

The average fractured exposure time in directed volar approach group and Henry approach group was (21.18 +/- 1.69) min and (12.56 +/- 1.35) min,operative time was (89.90 +/- 4.86) min and (61.58 +/- 4.37) min, postoperative median nerve irritation rate was 34.55% and 5.77%, and repair rate of the musculus pronator quadratus was 52.73% and 100%,respectively;there was statistical difference between two groups (P < 0.01). At the one-year after operation, GW score was 3.25 +/- 2.29,and with rate of excellent and good of 90.91% in directed volar approach group;in Henry approach group that was 2.92 +/- 2.13 and 92.31%, respectively; there was no statistical difference between two groups (P > 0.05). There was no statistical difference in range of motion of wrist joint, grasp force and imageology score between two groups (P > 0.05).

Henry approach can obtain the same operative result compared with directed volar approach in treating distal radius fractures. Henry approach has advantage of simple anatomy,easy operation,better repair rate of the the musculus pronator quadratus and lower postoperative median nerve complication,which should be used preferentially to treat distal radius fractures.