Dorsal Plating of Distal Radius Fractures

Abstract

The dorsal plates for the treatment of fractures of the distal radius have been indicated for several decades. The initial designs had rather rough screw heads and a high plate profile that interfered with the extensor tendons. The obvious consequence was an unacceptable frequency of irritation or extensor tendon rupture, together with a high incidence of need for plate removal. Since lower profile plates and smoother screw heads were developed, these complications became comparable to the more commonly used volar plates. The precise indications for dorsal plating are listed in this chapter. Three different dorsal approaches are described as well and 10 tips for special situations are given. Care must be taken to cover the plate and separate it from the extensor tendons to avoid complications. Nowadays, dorsal plates have a definitive place in the armamentarium of the surgeons for treating distal radial fractures.