Locking Plate for AO Type C Intra-articular Distal Radius Fracture: Volar or Dorsal Approach?

Purpose: There is controversy over the outcomes and complications of volar and dorsal plating for the treatment of intra-articular fracture distal radius. Methods: From 2008 to 2010, 81 patients with intra-articular fracture distal radius of AO type C1–C3 treated with distal radius locking plates via volar or dorsal approaches were reviewed in our institute. The clinical, radiological, and functional outcomes were evaluated at 6 months after operation. Results: The volar approach group showed a significantly better flexion range, flexion-extension arc as well as Green and O'Brien functional score than dorsal approach group. Volar tilting of the distal radius was significantly better in the dorsal group, but that did not contribute to better palmar–flexion range or grip strength. Overall complication rate was similar in both groups. Conclusion: The volar approach group demonstrated better range of motion and functional score. The complication rates were similar between the two groups. The volar surgical approach should be adopted in most operative cases of AO type C intra-articular fracture distal radius while the dorsal approach should be reserved for intra-articular fracture with dorsal comminuted fragments