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CC BY-NC-ND 4.0 · J Wrist Surg 2022; 11(03): 214-218
DOI: 10.1055/s-0041-1732338
Special Symposium: Volar Rim Distal Radius Fracture

Assessment and Management of Acute Volar Rim Fractures

John J. Heifner 
1   St. George's University School of Medicine, Great River, New York, New York
,
Jorge L. Orbay
2   The Miami Hand and Upper Extremity Institute, Miami, Florida
› Author Affiliations Funding None.
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Abstract

The volar rim of the distal radius is the only bony restraint to volar carpal subluxation. Higher loads across the volar rim require stable and rigid fixation to maintain reduction and allow healing while rehabilitation begins. Volar marginal fragments are not amenable to buttressing by fixed angle volar locking plates. Appropriate management of volar marginal fragments comprises two steps—recognition of their presence and rigid anatomical repair. The best opportunity for success in the presence of a volar marginal fragment is its adequate initial treatment. The purpose of this review is to reinforce the importance of a complete preoperative and intraoperative evaluation of distal radius fractures. Volar marginal fragments can easily be overlooked even following initial reduction and fixation. Understanding the relevant anatomy and loading parameters can facilitate intraoperative decisions on approach and fixation, which are integral to achieving optimal clinical outcomes.

Keywords

distal radius fracture - fragment specific fixation - volar marginal fragments - volar rim - watershed line


Publication History

Received: 22 March 2021

Accepted: 06 April 2021

Article published online:
30 July 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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