Ross M, Allen L, Couzens GB.
Journal of Hand Surgery 2015; 40(12):2465-2470.
Distal radius fractures are common injuries of the upper extremity requiring treatment. In recent years, volar locking plate (VLP) fixation has become favored for operative treatment with the main goals being anatomic reduction and rigid fixation allowing for an early range of motion rehabilitation protocol. VLP fixation is excellent at correcting sagittal plane alignment with restoration of volar tilt. However, plate designs do not have any intrinsic features to their designs to assist with correction of coronal plane translation. One possible sequela of distal radius fractures is residual instability of the distal radioulnar joint. This instability can lead to pain and disability after treatment of distal radius fractures requiring further interventions. It has been demonstrated that coronal plane malreduction with residual radial translation of the distal fragment may contribute to ongoing distal radioulnar joint instability after distal radius fractures. We describe a technique for intraoperative correction of residual radial translation. It may be used when radial translation is recognized during internal fixation with a VLP or when correction of radial translation is required as part of a corrective osteotomy for radial malunion.