Distal radial fractures: Volar, dorsal, fragment-specific, and spanning plates

The rate of operative treatment of distal radial fractures has risen significantly over the past 2 decades. Technological advancements in plating options have contributed to this trend. Volar locking plates have rapidly gained popularity as the technique of choice, but recent literature suggests that volar locking plates only provide short-term benefit with faster recovery of function but equivalent clinical results at 1yr when compared with external fixation and pins. Volar locking plates do result in improved radiographic results, so longer-term studies are needed for further analysis. Dorsal plating provides improved exposure of the articular surface, and newer generation low-profile dorsal plates have lower tendon-related complication rates. Dorsal spanning plates often are used in polytrauma patients with severe intraarticular fractures to restore length and alignment while facilitating immediate unrestricted use of the hand. Fragment-specific fixation uses customizable implants to assist with anatomic reduction of multifragmented, intraarticular fractures of the distal radius. Here, we provide an overview of literature published from 2013-2014 concerning volar, dorsal, fragment-specific, and spanning plate fixation, complications, and technological updates for the surgical treatment of distal radial fractures.