title: Complication rates and reduction potential of palmar versus dorsal locking plate osteosynthesis for the treatment of distal radius fractures.
abstract: BACKGROUND
  The aim of this study was to evaluate the complication rates of volar versus dorsal locking plates and postoperative reduction potential after distal radius fractures.
  
  
  METHODS
  For this study 285 distal radius fractures (280 patients/59.4 % female) treated with locked plating were retrospectively evaluated. The mean age of the patients was 54.6 years (SD 17.4) and the mean follow-up was 33.2 months (SD 17.2). The palmar approach was used in 225 cases and the dorsal approach in 60 cases (95 % type C fractures).
  
  
  RESULTS
  Adequate reduction was achieved with both approaches, regardless of fracture severity. In the dorsal group, the complications and implant removal rates were significantly higher and the operative time was also longer.
  
  
  CONCLUSIONS
  Based on these facts, we advocate the palmar locking plate for the vast majority of fractures. In cases of complex multifragmentary articular fractures where no compromise in reduction is acceptable, and with the biomechanical equality of palmar and dorsal plating remaining unproven, dorsal plating may still be considered.
  
  
  METHODS
  Therapeutic level IV.
authors.affiliation: Center for Musculoskeletal Surgery, Charité,Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Wichlas
authors.forename: N P
authors.initials: NP
authors.lastname: Haas
authors.forename: A
authors.initials: A
authors.lastname: Disch
authors.forename: D
authors.initials: D
authors.lastname: Machó
authors.forename: S
authors.initials: S
authors.lastname: Tsitsilonis
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011474:Prosthesis Design; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*