Volar plate fixation in intra-articular distal radius fractures with a volar lunate facet fragment.

The aims of the study were to determine whether a volar lunate facet fragment is present in 67 displaced intra-articular distal radius fractures and to investigate which factors are associated with reduction loss after treatment with a volar plate and locking screws. The fractures were analyzed preoperatively with three-dimensional computed tomography. The volar lunate facet fragment was present in 42 fractures. Reduction loss occurred in five wrists and in two of those, the carpus was subluxated. Loss of reduction was associated with a short palmar cortex (9mm or less) of the volar lunate facet fragment. This study has shown that measuring the length of the palmar cortex of a volar lunate facet fracture fragment may be useful for identifying distal radius fractures that have a higher risk of displacement after treatment with a standard volar plate and locking screws.