Complications of Volar Plate for Distal Radius Fracture

A distal radius fracture is the most common upper extremity fracture. Traditionally, the fracture was treated with conventional T plates, external fixators, pinning, or cast immobilization. Since 2002, the popularity of the volar locking plate (VLP) technique for the treatment of distal radius fractures has exploded. It achieves rigid fixation of the distal fragment of the radius, even in comminuted intra-articular fractures, introduces earlier rehabilitation, and results in successful outcomes. However, several complications are reported in the literature, such as rupture of the flexor pollicis longus or extensor pollicis longus, screw penetration onto the articular cartilage of the radius, loss of reduction, and ulnar side wrist pain. All of these complications worsen the clinical outcome and require additional surgical treatment(s).

This issue of the Journal of Wrist Surgery includes a “Special Review” by Drs. Goorens, van Eetvelde, Debaenst, and Royen entitled “A stepwise intraoperative protocol to minimize complications after volar plating.” This review describes a clever protocol to minimize complications of volar plating of distal radius fractures. The “WRIST” approach that comprises “wrist anatomy,” “range of motion,” “instability,” “Soong classification,” and “TFCC” is easy to remember. Please have a “WRIST” checklist to avoid any complication of volar locking plating for distal radius fractures.

This issue also contains interesting articles on the wrist, such as the distal radius fracture/malunion, total wrist fusion, carpal instability, and the anatomy of the wrist ligaments, and case reports, surveys, and new procedures. Don't miss it.

Publication History

Article published online:
12 October 2023