Clinical Study of Volar Median Approach Combined with Lateral Radial Auxiliary Approach in Treatment of C-Type Distal Radius Fractures: Our Clinical and Radiological Results

Abstract

BACKGROUND The aim of the study was to explore the clinical implications of median approach combined with radial auxiliary plate in the treatment of C-type distal radius fractures. MATERIAL AND METHODS From January 2017 to January 2022, a total of 20 cases were collected, including 6 male and 14 female patients with closed fresh distal radius fractures. All patients received volar medium approach T-shaped locking plate treatment, as well as radial auxiliary plate open reduction and internal fixation. We recorded the incidence of median nerve injury, incidence of radial artery and vein or their branches injury, postoperative X-ray measurement of radial styloid process height, ulnar declination, palmar inclination, and Gartland-Werley score. RESULTS All surgical procedures were successful, and all patients were monitored for 3 to 12 months after the procedure. In the postoperative follow-up, there was no obvious loss of reduction. At the last follow-up, all patients' articular surface flatness was less than 2 mm, and the mean values for palmar inclination and ulnar declination were (14.36°±3.55°) and (19.79°±2.57°), respectively. The average height of a radial styloid was 117±2.42 mm; functional evaluation: excellent in 12 (60%), good in 6 (30%), and fair in 2 cases (10%) cases. Five patients showed slight nerve injury, but all recovered quickly within 6 months. CONCLUSIONS The volar median approach, which combines a T-locking plate with a radial auxiliary plate for open reduction and internal fixation, is an effective treatment for unstable distal radius fractures.

Figure 1

Diagram for distal radius fracture surgery. The medial approach and radial auxiliary approach were used.

Figure 2

(A) X-ray and 3D CT examination of a typical surgical case prior to surgery. (B) Sharing of a typical case’s operation process. (C) X-ray examination of a typical case 3 months after surgery.