[Results of a volar approach to plate osteosynthesis of radius shaft fractures. Theoretical basis--clinical results].

This retrospective study analyses the results of 80 shaft fractures of the radius treated by open reduction and plating by a volar approach. Studies about strain distribution on the radius shaft worked out a varying pattern of tensile forces and a continuously change of the tension bend side through full range of motion. So from the biomechanical aspect an ideal position for compression plating is not determined and dorsal or volar plating brings the same stability. The advantage of the volar approach by Henry is the possibility of an easy extension of the approach to the distal or proximal part of the forearm and an optimal covering of the plate by soft tissue. To expose the superficial radial nerve is obligate, if necessary the deep radial nerve should be exposed too in proximal fractures. From 1973 to 1987 80 fractures of the shaft of the radius were treated by plating using the volar approach, since 1977 3.5 dynamic compression plate of the AO was used exclusively. Only two non-unions occurred in the beginning when the AO's third tube plate was used routinely. One massive callus formation had to be noticed with a complete loss of pronation and supination. One infection occurred, but normal wound healing and bone union could be achieved after early reoperation. Two incomplete lesions of the superficial radial nerve were seen, but normal sensibility occurred spontaneously. No other neural or vascular complication had to be noticed using this approach. In the follow-up 56 patients were seen two to 14 years postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)