Complication rates and reduction potential of palmar versus dorsal locking plate osteosynthesis for the treatment of distal radius fractures

F Wichlas, N P Haas, A Disch, D Machó, S Tsitsilonis
Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology 2014, 15 (4): 259-64

BACKGROUND: The aim of this study was to evaluate the complication rates of volar versus dorsal locking plates and postoperative reduction potential after distal radius fractures.

MATERIALS AND METHODS: For this study 285 distal radius fractures (280 patients/59.4 % female) treated with locked plating were retrospectively evaluated. The mean age of the patients was 54.6 years (SD 17.4) and the mean follow-up was 33.2 months (SD 17.2). The palmar approach was used in 225 cases and the dorsal approach in 60 cases (95 % type C fractures).

RESULTS: Adequate reduction was achieved with both approaches, regardless of fracture severity. In the dorsal group, the complications and implant removal rates were significantly higher and the operative time was also longer.

CONCLUSIONS: Based on these facts, we advocate the palmar locking plate for the vast majority of fractures. In cases of complex multifragmentary articular fractures where no compromise in reduction is acceptable, and with the biomechanical equality of palmar and dorsal plating remaining unproven, dorsal plating may still be considered.

LEVEL OF EVIDENCE: Therapeutic level IV.

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