Volar Plate/Hook Pin for Volar Lunate Facet Fragment

Abstract

Intra-articular fractures of the distal radius that include a separate coronal plane fragment at the volar lunate facet represent a difficult subset of fractures. They are often challenging to identify on initial radiographs. Furthermore, gaining adequate fixation in an often small, unstable lunate facet fragment is deceivingly difficult to achieve with standard volar plating techniques. Loss of fixation in the volar lunate facet fragment can result in volar subluxation of the carpus, resulting in malunion and carpal instability. Recognition of this fracture pattern and performing adequate fixation is imperative for a good outcome. This chapter describes this fracture with tips for recognition and fixation based on a case example.