Abstract
Background To assess the results of distal radius fractures with the involvement of the volar
rim fixed with the DePuy-Synthes Volar Rim Plate.
Case Description We searched for the patients with volar rim fracture and/or volar rim fractures as
part of a complex fracture fixed with a volar rim plate. Ten patients met the inclusion
criteria: three patients with type 23B3, six patients with type 23C, and one patient
with very distal type 23A. The mean follow-up was 14 months (range: 2–26). Fractures
healed in all patients. Of the three patients with isolated volar rim fractures (type
23B3), two patients had no detectable deficits in motion. These patients had an average
Gartland and Werley score of 9 (range: 2–14). Of the other seven patients (six with
type 23C and one with type 23A fracture), three patients healed with full range of
motion and four had some deficits in range of motion. Two patients had excellent results,
three had good results, and two had fair results using the Gartland and Werley categorical
rating. One patient healed with a shortened radius and ulnar impingement requiring
a second surgery for ulnar head resection arthroplasty.
Literature Review Results after nonoperative treatment of volar rim fractures are not satisfactory
and often require subsequent corrective osteotomy. Satisfactory outcomes are achieved
when the fragments are well reduced and secured regardless of the device type.
Clinical Relevance Volar rim plates give an adequate buttress of the volar radius distal to volar projection
of the lunate facet and do not interfere with wrist mobility. Furthermore, the dorsal
fragments can be fixed securely through the volar approach eliminating the need for
a secondary posterior incision. However, patients should be informed of the potential
problems and the need to remove the plate if symptoms develop.
Keywords
volar rim fracture - volar rim plate - distal radius fracture
