Combination of volar buttress plate with external fixator for the distal radial fractures of type C3 caused by high energy injuries

Objective:To preliminarily explore the effect of combination of volar buttress plate with external fixator for the distal radial fractures of type C3 caused by high energy injuries. Methods:From January 2001 to June 2007,13 patients with distal radial fracture of type C3,9 males and 4 females aged from 26 to 47 (average 37 years),were treated with volar buttress plate combined with external fixator plus the techniques of K wires and bone grafting as necessary,whose effects were evaluated preliminarily through comparing the volar tilt,radial inclination,radial shortening and wrist function. Results:Followed up from 7 to 29 months (average 18 months),the volar tilt,radial inclination,radial shortening and wrist function of all patients recovered remarkably. Nine patients achieved excellent and 4 good according to Sarmiento score(modified by Stewart) in the radiological manifestation,while 5 patients displayed excellent,6 good,and 2 fair according to Gartland-Werley functional assessment system. Conclusion: ①Volar buttress plate could support the valor cortex in order to prevent comminuted fragment from displacing and maintain volar tilt and to provide the volar fulcrum for external fixator. ②External fixator,with the assistance of volar fulcrum,could maintain the volar tilt and the height of distal radius and help unload the fossa. ③Supplemental K-wires fixation and the bone graft may assist fracture stable.