The purpose of this study is to compare the stability of internal fixation of an extra-articular dorsally unstable distal radius fracture with either a standard dorsal non-locked T-plate or a volar locked fixed-angle plate.
This study used six matched pairs of fresh frozen cadavers in simulated unstable extra-articular fractures. The specimens were loaded at five points and then cyclically loaded for 5000 cycles with an AD Newton central load. The specimens were assessed for initial fixation stiffness and stiffness after mid-axial cyclical loading.
The volar locked fixed-angle plate was significantly stiffer than the dorsal non-locked T-plate. After cyclical loading, the locked volar fixed-angle plate maintained more of its initial stiffness than the dorsal non-locked T-plate.
This study reinforces the conclusion that a volar locked plate provides a greater degree of stiffness than a dorsal non-locked plate. However, the question is really not which is stronger, but what strength is necessary to stabilize a fracture and maintain reduction. The advantages of palmar plating may relate more to ease of reduction the ability to avoid the dorsal surface of the bone where comminution exists and tendon problems can occur.
J Orthop Trauma