From the Research
The treatment of a distal radius fracture using a T-plate involves surgical fixation through open reduction and internal fixation (ORIF) with a volar approach, as it provides good exposure of the fracture site while minimizing complications, as supported by the most recent study 1.
Step-by-Step Procedure
The procedure for treating a fracture of the distal end of the radius with a T-plate involves:
- Administering anesthesia, either general or regional block, to ensure patient comfort during the procedure.
- Making an incision on the volar (palm-side) aspect of the wrist, typically following the flexor carpi radialis tendon, to access the fracture site.
- Dissecting through soft tissues and retracting the flexor tendons to expose the fracture fragments.
- Reducing the fracture fragments to their anatomical position, using fluoroscopy (real-time X-ray) to confirm proper reduction.
- Positioning the T-plate on the volar surface of the distal radius and securing it with screws, with shorter screws placed in the distal fragment to avoid penetrating the joint surface and longer screws in the radial shaft for stability.
- Irrigating the wound and closing it in layers after fixation.
Post-Operative Care
Post-operatively, the wrist is immobilized in a splint for 1-2 weeks, followed by early range of motion exercises. Physical therapy typically begins 2-4 weeks after surgery to restore function. This approach provides stable fixation that allows for early mobilization, which helps prevent stiffness and promotes better functional outcomes, as seen in studies such as 2.
Key Considerations
- The choice of plate fixation should depend on fracture type, patient factors, and surgeon experience, as highlighted in 1.
- The volar approach is preferred as it avoids the extensor tendons and provides good exposure of the fracture site while minimizing complications.
- Combined volar T-plating and dorsal pi-plating can yield good functional and radiographic outcomes for complex fracture patterns, as shown in 2.
- Bridge plate fixation is an alternative option for certain fracture patterns and patient circumstances, as discussed in 3.