OBJECTIVETo investigate the internal fixation methods in the two different surgical approach to the unstable distal radius fractures.

METHODSFrom August 2006 to October 2010,47 patients with distal radius fractures were treated with open reduction and plate internal fixation. Among the patients, 21 patients were male and 26 patients were female,ranging in age from 39 to 73 years old. All the patients were divided into two groups: 32 patients were treated with plate fixation at the palm side with palm side incision (group A),including locking plate used in 27 patients and ordinary T shape plate used in 5 patients; 15 patients were treated with dorsal plate fixation (group B), including locking plate used in 7 patients and ordinpry T shape plate used in 8 patients. The postoperative wrist function, X-ray score,complications were compared between the two groups.

RESULTSCompare to preoperative, postoperative volar tilt,ulnar deviation and radial styloid height of both groups improved; and comparison between 1 week after operation and 6 months after operation,volar tilt,ulnar deviation and radial styloid height of both groups had no obvious loss. In group A, 1 patient had tension injury of median nerve, 1 patient had incision infection, 2 patients had adhesion of tendon; and in group B,1 patient had incision swelling and infection, 1 patient had adhesion of tendon,3 patients had stimulation of extensor pollicis longus muscle tendon. The complication occurrence rate of group A is lower than that of group B. The wrist functional assessment: 17 patients got an excellent results, 11 good, 3 poor and 1 bad in group A; and 8 excellent, 4 good, 2 poor and 1 bad in group B. There was no statistically significant difference of wrist function between the two groups.

CONCLUSIONPlate fixation at the palm side for the treatment of unstable distal radius fractures can also achieve a good reduction,and has less complication such as tendon damage than that of dorsal plate fixation.