Suboptimal positioning of fragment-specific palmar distal radius plates

The EFCR Approach and the Radial Septum-Understanding the Anatomy and Improving Volar Exposure for Distal Radius Fractures: Imagine What You Could Do With an Extra Inch

Locked volar plating is the most common surgical procedure to address distal radius fractures. The extended flexor carpi radialis approach continues to be an excellent method for visualizing distal radius fractures and applying a volar plate. A new understanding of the anatomy allows for better visualization and reduction of the many different distal radius fracture patterns surgeons commonly see. Within the extended flexor carpi radialis approach, we describe the radial septum in further detail including the anatomy which comprises the radial septum triangle. Knowledge of this area allows for better visualization, more anatomic reductions, and fewer complications.

In Vivo changes in the lengths of carpal ligaments after mild dorsal angulation of distal radius fractures

The need for surgical correction in patients with malunion with mild dorsal angulation after a distal radius fracture is controversial. We specifically investigated in vivo changes in the lengths of carpal ligaments in a group of patients with mild-degree dorsal angulation following a distal radial fracture. We obtained computed tomography scans of both wrists in eight patients, whose distal radius on one side had united with dorsal angulation from 10° to 20°. The three-dimensional images of the carpus were reconstructed and the lengths of wrist ligaments were measured based on known anatomical landmarks. Compared with the contralateral uninjured side, the dorsal radiocarpal ligament and ulnotriquetral ligament were substantially lengthened (p < 0.05) and the long radiolunate ligament was substantially shortened (p < 0.05) at most wrist positions except extension. However, five other ligaments that we measured did not show significant differences in length compared with those of the uninjured side (p > 0.05). The lengths of some ligaments are substantially altered even by mild dorsal angulation of the distal radius, while the lengths of most other ligaments are not substantially affected.