Operative treatment and outcome of unstable distal radial fractures using a palmar T-miniplate at a non-specialized institution

Physiotherapeutic Approach for Volar Barton Fracture Left Side Without Neurological Deficits: A Case Report

Distal radius bone fracture termed a volar Barton fracture takes place when the ventral portion of the bone is displaced. This fracture happens obliquely within the joint itself. This is the case report of a 52-year-old female, who met with a road traffic accident and injured her left wrist. After the necessary investigation, she was diagnosed with a volar Barton fracture of the left wrist without any neurological deficits. After this, she was managed with open reduction and internal fixation with plate osteosynthesis. Postoperatively, the patient complained of pain around the left wrist joint and there was also restriction in the movements of the left wrist, which caused it to be difficult to perform everyday tasks. We report that following surgery, physical therapy intervention significantly reduced the intensity of pain, improved the range of motion, and strength of the muscle, and remarkable progress in the patient's functional independence. An Upper Extremity Functional Index was used as an outcome measure.

A comparison of minimally invasive approach vs conventional approach for volar plating of distal radial fractures

Background

The aim of this study was to introduce and to evaluate the functional results of volar plating of distal radial fractures through a longitudinal minimally invasive approach.

Methods

From January 2010 to January 2013, 157 patients with distal radial fractures were randomly allocated to group A (n = 83; 49 men, 34 women; mean age: 42 (18–67)) and B (n = 74; 46 men, 28 women; mean age: 41 (22–65)), including type A2, A3, B3, C1, and C2 fractures, based on AO Foundation and Orthopaedic Trauma Association Classification. Patients in group A were treated through a 1.5- to 2-cm longitudinal incision, and patients in group B were treated through the conventional flexor carpi radialis approach. All fractures were treated with a locking volar plate. The functional results were compared with range of motion, grip and pronation strengths for each fracture type.

Results

After a follow-up of 2 years, similar measurements were noted on range of motion and grip strength in both groups. Regarding pronation strength, group A was superior to group B (p < 0.05).

Conclusions

Minimally invasive volar plating of distal radial fractures is a safe and reliable technique, resulting in better pronation function and appearance.

Level of Evidence

Level I, Therapeutic study