Abstract
Not all distal radius fractures, in terms of fracture anatomy and patient characteristics, are amenable to volar locked plating which has become a mainstay of treatment. Dorsal bridge plating for highly comminuted distal radius fractures with metaphyseal and diaphyseal extension has been shown to be a useful technique in attaining stability through ligamentotaxis. It is also useful in polytrauma patients requiring immediate weight bearing. The technique involves a closed reduction maneuver to reduce the fracture fragments with the application of longitudinal traction. The bridge plate is inserted through limited incisions over the radial shaft and the 2nd metacarpal, resting extraperiosteally in the 2nd dorsal compartment. The plate is secured with both locking and non-locking screws. Patients are allowed immediate weight bearing on the injured extremity through the forearm. The plate is removed after fracture healing, no earlier than 12 weeks. Studies have shown fracture union and functional range of motion postoperatively without excessive finger stiffness or reflex sympathetic dystrophy. Dorsal distal radius bridge plating is a useful technique in specific clinical situations.
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