chapter  21
8 Pages

Dorsal Nail Plate Fixation for Distal Radius Fractures

The treatment of distal radius fractures has evolved as a variety

of management techniques have been introduced. These

include closed reduction and immobilization with splints or

casts (1-3), extrafocal or intrafocal percutaneous pinning (4-8),

external fixation (9-14), and different methods of internal

fixation (15-19). Nonetheless, fixation failure in osteoporotic

bone, poor reduction, and reflex sympathetic dystrophy remain

a concern for all techniques (20-24). Open reduction and

internal fixation performed by various methods has recently

gained acceptance, especially when stable reduction cannot be

achieved by manipulative means. Conventional buttress plate

fixation, however, has proven inadequate for the majority of

dorsal injuries due to poor fixation and frequent soft tissue

complications (25-29). For these reasons, fixed-angle internal

fixation through a dorsal or volar approach has been advocated.

The latter presents the advantage of avoiding extensor tendon

dysfunction (30,31). Most importantly, with fixed-angle fixation,

early range of motion can be initiated promptly even in patients

with poor bone stock (32,33).