Distal Radius Fracture Repair with Volar Plate

This procedure uses a metal implant to stabilize a fracture in the radius near the wrist. The radius is the largest of the two bones of the forearm.

The distal radius is the larger of the two bones in the forearm. Because a fracture of the distal radius usually occurs approximately 1 inch from its end, which is close to where it connects to the bones of the hand near the thumb, it is usually referred to as a "broken wrist." In the United States, distal radius fractures account for approximately 70 percent of all forearm fractures, and are typically the result of landing on a hand that has been extended to break a fall, or of a sports-related injury. In addition, the elderly and those who have osteoporosis are prone to distal radius fractures because of the fragility of their bones.

Distal radius fractures may be treated effectively by wearing a supportive cast or splint. For severe distal radius fractures, surgery may be necessary. Distal radius fracture repair with volar plate is a surgical procedure that uses metal implants, or plates, to help stabilize fractures in the radius near the wrist.

Causes of Distal Radius Fracture

Distal radius fractures are most commonly caused by falling directly onto an outstretched arm. Patients over the age of 60 who have osteoporosis are especially vulnerable to these fractures, since this disorder causes bones to become weaker and therefore much more likely to break. However, a distal radius fracture may occur in patients with healthy bones if there is severe trauma, such as a major impact sustained during a motor vehicle accident or sports injury.

Symptoms of a Distal Radius Fracture

Symptoms of a distal radius fracture usually include the following:

  • Immediate pain, particularly during wrist flexion
  • Tenderness
  • Bruising
  • Swelling
  • Crooked, deformed or bent-looking wrist

Types of Distal Radius Fractures

There are several different types of distal radius fractures that can occur. Distal radius fractures can be intra-articular, extending into the wrist joint, or extra-articular, not involving the wrist joint. Intra-articular distal radius fractures are more difficult to treat than extra-articular ones.

Open distal fractures occur when the bone breaks the skin. Open distal fractures can be extremely serious, and require immediate medical attention. To diagnose a distal radius fracture, a physical examination is performed and X-rays are taken to determine the severity and exact location of the break.

Distal Radius Fracture Repair with Volar Plate Procedure

Distal radius fracture repair with volar plate is an outpatient procedure, performed when a distal radius fracture cannot be repaired by wearing a splint or cast. If a patient experiences an open distal radius fracture, in which the bone becomes visible through the skin, the surgery must be performed within 8 hours of the initial injury to prevent further damage. During this procedure, the patient will be positioned so that the surgeon has unobstructed access to the palm side of the forearm. An anesthetic is administered and the targeted surgical area is sterilized.

An incision is made to gain access to the fracture so the broken bones can be realigned. In addition, a metal plate will be shaped to precisely fit the radius. The metal plate is then inserted against the newly realigned bone. Metal surgical screws or pins are used to anchor the plate to the bone, restoring stability. Once the surgery is complete, the incision is closed with sutures and the arm is bandaged and placed in a cast or splint. Patients are typically able to return home the same day, although they will need to wear the cast or splint for 6 weeks after surgery.

Recovery from Distal Radius Fracture Repair with Volar Plate

While a full recovery from distal radius fracture repair with volar plate may take up to a year, many patients are able to return to their normal activities after about 2 months. Hand therapy may be required following distal radius fracture repair with volar plate. Hand therapy programs combine nonsurgical treatments with physical exercises to help restore the strength and range of motion in the patient's hand and arm.

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  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics