Fragment-specific volar hook plate for volar marginal rim fractures

Abstract

The volar lunate facet/volar marginal rim fragment of distal radius fractures is a challenging problem for current volar plating systems to adequately maintain internal fixation. Fragment-specific wireforms and other constructs can be used to capture these difficult fragments but are difficult to place and have limited resistance to bending and axial load. Fixed-angle volar plates have limited distal translation without increasing the risk of flexor tendon rupture. Failure to reduce and maintain reduction of these volar ulnar intra-articular distal marginal rim fractures result in disastrous volar carpal subluxation. We present an alternative surgical technique using a low-profile volar hook plate designed specifically to address this fragment. The first 6 cases are presented here with no observed surgical complications to date.