gms | German Medical Science

Objectives/Interrogation: Volar rim fragment of distal radius fracture supports the carpal bones and is challenging for the rigid fixation. We investigated the outcome of volar plate buttress on the bended Kirschner wire fixation for the displaced volar rim fragment of distal radius comminuted fracture.

Methods: 2 cases with the volar rim fragment of distal radius fracture, which displaced after the initial surgery, were enrolled in this study.

Case 1 was 51-year-old woman and sustained volar Barton fracture. 6 months after the initial surgery with volar locking plate, she had the plate removal. However, the fragment got displaced. Case 2 was 73-year-old woman and had comminuted Smith fracture. 1 week after the initial surgeries with volar locking plate, Plain radiography showed displaced volar rim fragment (Figure 1 [Fig. 1]).

In the surgery, the volar rim fragment was reduced and fixed with titanium Kirschner wires. The wires were bended to fit the volar cortex of the radius. Volar locking plate applied on the wires and was fixed with screws to buttress the wires and the fragment (Figure 2 [Fig. 2]).

Results and Conclusions: At the final follow-up, they had no pain. Flexion/extension recovered into 50/60 and 40/50 respectively. Bone union of the fragment was confirmed by plain radiography and CT.

This method used the standard instrument without special plate and complex technique. The volar rim fragment could be fixed rigidly by buttressing the wires with the plate, and favorable outcome was obtained. Thus, this method is an option for the fixation of the volar rim fragment.