J Wrist Surg 2016; 05(02): 113-119
DOI: 10.1055/s-0036-1579549
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Stabilization of Volar Ulnar Rim Fractures of the Distal Radius: Current Techniques and Review of the Literature

Maureen A. O'Shaughnessy
1   Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Alexander Y. Shin
1   Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Sanjeev Kakar
1   Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

18 January 2016

20 January 2016

Publication Date:
29 February 2016 (online)

Abstract

Background Distal radius fractures involving the lunate facet can be challenging to manage. Reports have shown the volar carpal subluxation/dislocation that can occur if the facet is not appropriately stabilized.

Literature Review Recent emphasis in the literature has underscored the difficulty in managing this fracture fragment, suggesting standard volar plates may not be able to adequately stabilize the fragment. This article reviews the current literature with a special emphasis on fixation with a specifically designed fragment-specific hook plate to secure the lunate facet.

Case Description An extended flexor carpi radialis volar approach was made which allows access to the distal volar ulnar fracture fragment. Once provisionally stabilized with Kirschner wire fixation, a volar hook plate was applied to capture this fragment. Additional fracture stabilization was used as deemed necessary to stabilize the remaining distal radius fracture.

Clinical Relevance The volar marginal rim fragment remains a challenge in distal radius fracture management. Use of a hook plate to address the volar ulnar corner allows for stable fixation without loss of reduction at intermediate-term follow-up.

 
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