title: Devising for a distal radius fracture fixation focus on the intra-articular volar dislocated fragment.
abstract: BACKGROUND
  Distal radius fracture (DRF) accompanied by intra-articular volar displaced fragment is difficult to reduce. This volar fragment remains when treated with a simple buttress effect alone, and V-shaped deformity may remain on the articular surface. We attempted to improve dorsal rotational deviation of volar fragment by osteosynthesis applying the condylar stabilizing technique. We report the surgical procedure and results.
  
  
  METHODS
  The subjects were 10 cases of DRF accompanied by intra-articular volar displaced fragments surgically treated (mean age: 69 years old). The fracture type based on the AO classification was B3 in 1 case, C1 in 4, C2 in 2, and C3 in 3 cases. All cases were treated with a volar locking plate. Reduction was applied utilizing the angle stability of the volar locking plate, similarly to the condylar stabilizing technique. On the final follow-up, we evaluated clinical and radiologic evaluation. To evaluate V-shaped valley deformity of the articular surface, the depth of the lunate fossa of the radius was measured using computed tomography (CT).
  
  
  RESULTS
  The duration of postoperative follow-up was 11 (6-24) months. Mayo wrist score was 93 (Excellent in 10 cases). No general complication associated with a volar locking plate was noted in any case. Volar tilt on radiography were 11° (4-14). The depth of the lunate fossa on CT was 3.9 ± 0.7 mm in the patients.
  
  
  CONCLUSIONS
  This procedure may be useful for osteosynthesis of distal radius fracture accompanied by intra-articular volar displaced fragments.
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sugiyama
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Japan; Department of Orthopaedics, Juntendo University School of Medicine, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Naito
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Obata
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Japan.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Aritomi
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Obayashi
keywords: Condylar stabilizing technique; Distal radius fracture; Hook plate; Volar Barton fragment