Volar locking compression plate fixation for dorsally displaced fractures of distal radius

[Objective]To evaluate a preliminary outcome of volar surgical treatment of dorsally displaced fractures of distal radius with open reduction and internal fixation with T shape locking compression plate(TLCP).[Method]From Sept.2003 to Nov.2005,9 cases with dorsally unstable distal radius fractures were treated with open reduction and internal fixation with T-LCP.This study involved 3 males and 6 femals with an average age of 63.5 years(ranged from 52 to 74 years old).According to AO classification: 2 cases of types B2;1 case of type B3;2 cases of type C1;3 cases of type C2;1 case of type C3,all of them were closed fractures of distal radius.The fractures of 9 cases were fixated with T-LCP by volar approach and dorsal soft tissues were not dissected during the operation.The Osteosets and the artificial bone substitute were implanted into bone defects if they were large enough.[Result]Nine cases were followed up for 6 to 17 months and the average time was 10.7 months.The X-ray pictures showed that unions have been achieved in all patients and a mean healing time was 7 weeks.The Osteosets were implanted into large bone defects in one case.No complication was found as infection,non-union,loosing of nails,syndrome of wrist,and medium neuritis.The functional recovery was achieved from 6 to 29 weeks with an average time of 12.5 weeks after operation.Passive wrist motion,active finger motion and forearm rotation were encouraged immediately after surgery.Active wrist motion was suggested in 7 days postoperatively.The clinical outcomes were evaluated according to modified Mcbide grading system.There were 7 excellent,1 good and 1 fair,the satisfactory rate was 88.9%.[Conclusion]The volar fixation of T-LCP for dorsally displaced fractures of distal radius has a good clinical outcome.It allows the patients to begin early exercise.