Palmar Z-Osteotomy for Distal Radius Fractures

<b>Background:</b> Distal radius fractures (DRFs) are a common injury with fracture parameters guiding surgical treatment. Palmar plating is the most common method of fixation in patients needing surgical fixation. However, in fractures with a complete or nearly intact volar cortex, reduction of the fracture fragments may be challenging with the palmar approach. We use a novel Z-osteotomy technique to address this issue and report on our outcomes. <b>Methods:</b> This is a retrospective review of all patients where a volar Z-osteotomy technique was used. We assessed pre-, intra- and postoperative radiographic parameters, fracture union and final wrist range of motion of all patients. <b>Results:</b> Twelve DRFs in 11 patients were analysed. All fractures were successfully plated palmarly with volar tilt 9-14 (average: 11.3) and all achieved fracture union. This was maintained in the final radiographs with good clinical wrist range of motion. <b>Conclusions:</b> The volar Z-osteotomy technique described allows surgeons to achieve anatomical reduction of volar tilt in DRFs where the volar cortex is intact with good clinical and radiological outcomes. <b>Level of Evidence:</b> Level IV (Therapeutic).