Volar T-shape plate fixation for unstable distal radius fractures in the elderly patient

[Objective]To evaluate outcome of the treatment of unstable distal radius fractures in the elderly patient using a volar T-shape plate.[Method]From January 2001 to April 2003,42 cases with unstable distal radius fractures older than 60 years(range 60～75 years;mean age 65.1 years) were treated with a T-shape plate fixation.The fractures were classified according to the AO classification of distal radius fracture: 4 A2,7 A3,5 B1,3 B3,9 C l,11 C2,3 C3.Artificial bone graft substitutes were used in 28 cases with severe cortex destruction and insufficient buttress.[Result]All patients were followed up(mean 18.2months,range 12～24months).Final volar tilt was averaged 3.66° and radial tilt 20.1°,and radial shortening averaged 1.59 mm in 6 cases.Step-off or gap of the articular surface was found in 6 cases(mean 1 mm,range 1～5 mm).The average final volar flexion was 58.2°,dorsifixion 55.6°,pronation 79.2°,and supination 70.1°.Grip strength was 65% of the contralateral side.According to the system of Gartland and Werley as modified by Sarmiento,there were 25 excellent,11 good,4 fair and 2 poor.[Conclusion]The treatment of unstable distal radius fractures in the elderly patient with a volar T-shape plate is a safe and effective method.This technique provided stable internal fixation and allowed early function while avoiding the complications inherent in the dorsal approach.