Volar approach combined with small dorsal incision in the treatment of AO type C distal radius fracture: A retrospective cohort study

This study aims to explore the clinical efficacy of volar approach combined with small dorsal incision in the treatment of AO type C fracture of the distal radius. From January 2020 to December 2022, a total of 126 patients with AO type C fracture of the distal radius were treated. The treatment was conducted using a volar approach combined with a small dorsal incision. Initially, the Henry approach was employed from the volar side to expose the fracture site. Following reduction, Kirschner wires were used for temporary fixation. Subsequently, a small incision was made on the dorsal side to explore and assist in reducing the articular surface. Bone grafting was performed to support the collapsed articular surface, and Kirschner wires were again utilized to temporarily fix the joint surface bone fragments. Finally, a distal radius locking plate was positioned on the volar side. Routine rehabilitation exercises were initiated postoperatively, with follow-up visits scheduled at 1 month, 3 months, and 1 year after the procedure, accompanied by CT examinations. A total of 110 patients completed the follow-up, with an average duration of 13.8 months. All fractures achieved bony union at an average of 10.1 weeks. At the final follow-up, wrist function assessed by the Gartland and Werley scale was excellent in 68 cases, good in 33, and fair in 9. Radiographic parameters remained stable between postoperative and final follow-up assessments, with no significant differences in radial height (10.1 ± 3.6 mm vs 10.4 ± 3.5 mm, P > .05), radial inclination (20.8 ± 4.1° vs 20.4 ± 3.8°, P > .05), volar tilt (6.6 ± 4.4° vs 6.3 ± 4.6°, P > .05), or joint surface flatness (P > .05). Compared to the contralateral healthy side, the injured side exhibited significantly reduced mobility in both extension (70.8 ± 6.6° vs 82.5 ± 6.9°, P < .05) and flexion (70.6 ± 3.6° vs 87.5 ± 5.8°, P < .05). However, no significant differences were found in pronation (83.0 ± 4.7° vs 83.2 ± 4.1°, P > .05) or supination (85.5 ± 4.8° vs 85.7 ± 5.0°, P > .05). No major complications occurred. The volar approach combined with a small dorsal incision can achieve good clinical results in the treatment of AO type C fracture of the distal radius.