Evidence brief
Distal Radius Fracture Fixation: Volar Locking Plates
Volar approach avoids extensor tendon complications
Locking screws provide subchondral support
Allows early motion in most cases
Watershed line important for plate positioning
Revolutionized distal radius fracture treatment
Volar locking plate fixation has become the standard for unstable distal radius fractures. The technique provides stable fixation allowing early mobilization.
Know watershed line and safe plate positioning. Volar approach: between FCR and radial artery. Complications: FPL rupture (prominent plate), screw penetration. Know indications: unstable patterns (dorsal comminution, >2mm step, >20° dorsal tilt). Discuss fragment-specific fixation for complex patterns.
Orbay JL, Fernandez DL. Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report. J Hand Surg Am. 2002;27(2):205-215.
Level IV
Case series or case reports