Volar fixed-angle fixation of distal radius fractures: the DVR plate

Abstract

Volar fixed-angle fixation of distal radius fractures is a new method of treatment that provides the benefits of stable internal fixation without incurring the disadvantages of the dorsal approach. The DVR plate is a new fixation implant that was introduced specifically for the purpose of managing both dorsal and volar displaced fractures from the volar aspect. Experience gained applying volar fixed-angle fixation to clinically complex cases led to the description of a new surgical approach and to refinement in design of the implant. The need to reduce fractures with significant articular displacement and the need to debride dorsal organized hematoma or callus in old fractures led to the development of an extended form of the flexor carpi radialis approach that provides improved dorsal exposure by mobilizing the proximal radius out of the way and allows the use of the fracture plane for intrafocal exposure. The use of this implant in severely osteoporotic bone and in those fractures presenting severe articular fragmentation or displacement led to the improvement of its design. The plate's ability to stabilize the distal radius was optimized by taking full advantage of the principles of subchondral support and buttress fixation.