Distal radial fractures

Summary

There is insufficient evidence from four retrospective cohort studies to infer the advantage of either the volar or dorsal plating approach for treatment of distal radius fractures. Results suggest that dorsal plating may be more effective for restoration of palmar tilt. Overall, no differences in other radiographic measures or functional mobility were seen. There was tendency for patients with dorsal plates to have less motion for flexion and extension, but statistical comparison with volar plating was not reported. In all studies, plating choice was made based on surgeon discretion, which may tend to bias comparison of outcomes. Some studies were limited by small sample sizes and some may not have had inadequate follow-up to observe longer term outcomes. Randomized studies or comparative studies which account for confounding factors are needed in order to more effectively evaluate the potential superiority of either plating choice.