Evolution of Technology

Distal Radius Volar Locking Plate

The advent of volar locking plates has seemed to solve some of these issues. Popularized in the early 2000s, these plates allow for stable fixation of the fracture so that patients may begin early range of motion to prevent stiffness of the wrist joint and also do not irritate the tendons of the wrist because of their low-profile design.

Additionally, the advent of screws that lock in to the plate and prevent any motion between the plate and screw (also called “locking screws”) allow these plates to have keep the distal radius aligned appropriately. These volar locking plates have become commonplace in distal radius surgery for their versatility.

Evolution of Procedure

Distal Radius Fracture Surgery

One of the main goals of orthopedic surgery is restoration of pre-injury anatomy, and distal radius surgery is not exception. There exist many different options for surgical treatment of these fractures. One of the oldest techniques is external fixation, where pins are inserted to through the skin and connected by bars to hold the fracture reduced (i.e. straightened).

However, patients may develop an infection or lose range of motion at the wrist joint. Another option is using a plate with screws on the dorsal (opposite side of the palm) portion of the distal radius. These plates can be very prominent and can even cause the tendons that allow you to extend your fingers to rupture.

Another option is to place the plate on the volar (same side as the palm) portion of the distal radius. These plates don’t irritate the tendons like those placed dorsally, but they did not have the strength with traditional screws to prevent the fracture from moving and these fractures often healed in the incorrect alignment.

Evolution of Diagnosis

Distal Radius Fracture

Fractures of the distal radius are very common injuries to the upper extremity. People who are at high risk are the elderly, people with osteoporosis and specifically women who have already undergone menopause.

Fractures of the wrist can cause patients to miss work and prevent the use of the hands and wrist due to pain or immobilization in the cast. Some fractures of the radius can be treated with casting or bracing alone, but some fractures may require treatment with surgery. These patients tend to be younger and more active, or they have more complex fracture types involving the wrist joint itself.