Abstract:

Objective

To analyze the surgical effect of volar single plate fixation with a simple volar approach in patients with unstable fractures of the dorsal displaced distal radius.

Methods

102 patients diagnosed with dorsal displaced distal radius fractures undergoing sole palmar approach and palmar single steel plate fixation from May 2020 to June 2022 were selected as research subjects.Patient general information，operation time，intraoperative blood loss，fracture healing time，length of hospital stay，palmar tilt angle，ulnar variance，radial height，wrist joint function，joint activity and complications were recorded，and the efficacy and influencing factors of the surgery were analyzed.

Results

The 102 patients underwent surgery（59.56±11.91）min，intraoperative bleeding（67.45±12.70）mL，fracture healing time（11.94±3.42）weeks，and hospitalization （7.55±1.35） days， and the differences of different joint mobility indexes before， 1 month and 3 months were statistically significant（P＜0.05）.The results of pairwise comparison showed that dorsal extension ROM，palm flexion ROM，anterior ROM，posterior ROM，ulnar angle and radial height were significantly increased，and the difference was statistically significant（P＜0.05）.At 1 month and 3 months after surgery，it was significant（P＜0.05）.The effect of the affected side and different AO fracture types on patient surgery，rehabilitation outcomes and prognosis was not significant， and there was no statistically significant difference in baseline，perioperative，and rehabilitation outcome indicators for patients with different affected sides（P＞0.05）.From the perspective of patient complications，two patients had incision infections，three had nerve or tendon injuries and traction，three patients had tendon adhesions，and three patients had wrist joint pain，with a total incidence rate of 11 cases.There was a significant correlation between preoperative palmar flexion ROM，postoperative 1-month palmar flexion ROM， postoperative 3-month palmar flexion ROM， postoperative 1-month supination ROM，postoperative 1-month ulnar variance，wrist joint function，and the occurrence of complications after surgery（P＜0.05）.

Conclusions

Sole palmar approach and palmar single steel plate fixation is an effective method for treating dorsal displaced distal radius fractures，and can be used for patients with different affected sides and differentAO fracture types，promoting the recovery of wrist joint function.

Key words: Palmar approach, Single steel plate fixation, Distal radius fracture, Efficacy