title: Radiographic and functional evaluation of low profile dorsal versus volar plating for distal radius fractures.
abstract: BACKGROUND
  Fracture of the distal radius is a common clinical problem. Complex fracture requires open reduction and stabilization with plating to restore anatomy. Dorsal plating has advantages of buttressing the fracture better but often complicated with tendon problems as per literature. The rate of complications however, was not compared between the low-profile dorsal and the volar plates.
  
  
  METHODS
  This was a retrospective study on seventy one patients with dorsally angulated or displaced distal radius fractures, who underwent fixation of fractures with either dorsal or volar locking plate from Jan - Nov 2012. Preoperative radiographs were classified based on Universal and Fernandez classification. Postoperative radiographs were assessed for anatomical restoration of Radial length, radial inclination and volar tilt. Tendon and nerve related complications were assessed and functional evaluation was performed on the basis of PRWE (Patient related wrist evaluation) score.
  
  
  RESULTS
  Both groups were matched for their demographic profile and fracture types (p 0.033). Dorsal plating group had 89% excellent/good restoration and fair in 11%. Volar group had 96% excellent/good restoration and fair in 4%. Statistical analysis was performed with unpaired t test for radiographic parameters. Three patients had tendon related complications in dorsal plating group; two patients in volar group had nerve related complications. Functional outcome with PRWE was comparable between two groups.
  
  
  CONCLUSIONS
  Results with low profile dorsal plating were comparable to volar plating. Therefore dorsal plating can be used as an alternative method when dorsal buttressing of comminuted fracture is required, especially with concomitant osteoporosis.
authors: Department of Orthopaedics, Hillingdon Hospital NHS Trust, Pield Heath Lane, Uxbridge UB8 3NN, United Kingdom.
authors: Sanjay
authors: S
authors: Kumar
authors: Department of Orthopaedics, Southend University Hospital, Prittlewell Chase, Westcliff on sea SS0 0RY, United Kingdom.
authors: A N
authors: AN
authors: Khan
authors: Department of Orthopaedics, Bronglais General Hospital, Caradoc Road, Aberystwyth SY23 1ER, United Kingdom.
authors: S V
authors: SV
authors: Sonanis
keywords: Complications; Distal radius fracture; Dorsal plating; Low profile plates; Radiological comparison; Volar plating