title: [Selection of dorsal or volar internal fixation for unstable distal radius fractures].
abstract: OBJECTIVE
  To assess the results of T-plate in the treatment of unstable distal radius fractures.
  
  
  METHODS
  Dorsal or volar T-plate fixation was used for unstable distal radius fractures according to different types of fracture. For comminuted fractures with severe cortex destruction and insufficient buttress, artificial bone graft or autograft was adopted to restore local stability.
  
  
  RESULTS
  Satisfactory reduction was achieved after surgery. Functional rehabilitation under surveillance began from the 2nd or 3rd post-operative day. The overall excellent or good recovery rate was 90.77% after a mean follow-up of 29.63 months. For the 55 sides of volar fixation (30 sides with a dorsal displacement fragment), excellent or good recovery rate was 92.72%. Dorsal fixation was used in delayed cases (> 6 weeks) or certain fracture patterns unsuitable for volar approach. The excellent on good recovery rate was 77.77%.
  
  
  CONCLUSIONS
  Volar approach is an ideal option not only for distal radius fracture with a volar displaced fragment but also for dorsal displaced fractures (Colles' fracture). The advantages of this approach include flat cortex for easy plate fixation, better tension band effect, less soft tissue destruction, leaving dorsal soft tissue hinge intact, and avoiding bone graft leakage. Satisfactory results can be obtained in those patients with unstable distal radius fracture through volar approach plate fixation, especially in those with fresh fractures. If possible, volar approach can also be used in delayed fractures within 6 weeks. The results of dorsal fixation is a little bit inferior.
authors.affiliation: Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China.
authors.forename: Xiao-ying
authors.initials: XY
authors.lastname: Gong
authors.forename: Guo-wei
authors.initials: GW
authors.lastname: Rong
authors.forename: Gui-sheng
authors.initials: GS
authors.lastname: An
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Guo-zhu
authors.initials: GZ
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000601:surgery*