Treatment of the Distal Forearm Fracture by Volar Dual Window Approach

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Upper Extremity Reconstruction

Background:

• Distal forearm fractures, common in osteoporotic geriatric patients, traditionally treated with double incision approaches.
• Conventional methods may lead to malreduction and distal radioulnar joint instability.

Purpose of the Study:

• To introduce and evaluate a modified volar dual window approach for treating distal forearm fractures.
• To assess the functional outcomes and complication rates of this novel surgical technique.

Main Methods:

• 13 patients with distal forearm fractures underwent open reduction and internal fixation using a modified volar dual window approach with locking plates.
• Postoperative management included splinting for two weeks and a three-month hand therapy program.
• Data collected included functional scores (QuickDASH), range of motion, grip strength, radiographic parameters, and complications.

Main Results:

• The modified approach resulted in good bone union in all patients.
• Excellent functional outcomes were observed, with mean QuickDASH scores of 14 ± 11.5 and grip strength at 88% of the uninjured side.
• Postoperative radiographic parameters were within normal limits, and complications were minimal, with only two patients requiring implant removal for irritation.

Conclusions:

• The modified volar dual window approach provides effective reduction and good functional outcomes for distal forearm fractures.
• This technique is a viable alternative, especially for comminuted distal ulna fractures or distal radioulnar joint incongruity, without increased risks of neurovascular or wound healing issues.