Comparison of Volar Henry and Extended Flexor Carpi Radialis Approaches in the Surgical Treatment of Distal Radius Fractures

Abstract

Objectives: The aim of this study was to compare the clinical and radiological results of volar Henry (VH) and extended flexor carpi radialis (EFCR) approaches used for open reduction of distal radius fractures. Methods: We reviewed 85 patients with distal radius fractures treated with volar locking plates between 2014 and 2017. The EFCR approach was used in 30 (35.3%) patients, and the VH approach was used in 55 (64.7%) patients for open reduction. Clinical results were reviewed by the Quick Disability of the Arm, Shoulder and Hand; Patient-Related Wrist Evaluation; and Boston Carpal Tunnel Syndrome questionnaires. Bilateral wrist range of motion, grip, and pinch strengths were measured, and sensory evaluations were done with the Semmes-Weinstein monofilament test and static two-point discrimination tests. Radiological evaluations were done with final follow-up radiographs. Results: The mean age was 50.7, and the average follow-up time was 31.8 months. No differences were found between the two groups related to clinical and radiological outcome evaluations. In the VH group, six post-operative complex regional pain syndromes, one tendon rupture, three delayed carpal tunnel syndromes, and one osteomyelitis were observed. In the EFCR approach group, complex regional pain syndrome was observed in four patients. Conclusion: Similar clinical and radiological results were found with the EFCR approach and VH approach in the treatment of distal radius fractures. As the EFCR approach seems to be safe for routine open reduction of distal radius fractures, it should especially be kept in mind in cases with median nerve entrapment.