Volar Splinting After Distal Radius Plating: The Anatomic Rationale
Your provider chose a volar slab because the volar plating approach places hardware on the palm side of your wrist, and a volar splint provides direct support to the surgical site while avoiding pressure on the dorsal (back) side where extensor tendons run—this protects both the healing bone and prevents complications from the plate itself. 1
Why Volar Splinting Makes Anatomic Sense
The decision is driven by the surgical approach used:
Volar plating is the preferred surgical technique for distal radius fractures because it provides stable fixation and allows earlier recovery of function compared to other methods 1
The plate sits on the volar (palm) surface of your radius bone, directly beneath the flexor tendons and above the pronator quadratus muscle 2
A volar splint provides direct buttressing of the surgical construct from the same side where the hardware was placed, supporting the fracture fragments against gravity and functional loads 3
The Dorsal Complication Risk
Placing a dorsal splint after volar plating would be counterproductive:
Dorsal pressure could push the fracture fragments volarly against the plate in an unstable manner, potentially compromising reduction 3
The extensor tendons on the back of your wrist are vulnerable to irritation and rupture from dorsally protruding screws—a volar splint avoids adding any external pressure to this already at-risk area 4
Studies show dorsal plating itself causes tendon complications in up to 11% of cases due to hardware prominence, so avoiding dorsal pressure after volar plating is prudent 5
Immediate Postoperative Protocol
Your provider's approach aligns with current evidence:
Active finger motion should begin immediately after surgery to prevent stiffness, which is a common and preventable complication 1, 6
The splint must never obstruct full finger range of motion—this is critical to prevent the functionally disabling complication of finger stiffness 6
Early wrist motion is not routinely necessary following stable volar plate fixation, so the volar slab appropriately immobilizes the wrist while allowing finger movement 7, 1
Common Pitfall to Avoid
The most important caveat: failure to maintain active finger motion leads to severe stiffness requiring multiple therapy visits or even surgical intervention—this is entirely preventable with immediate mobilization of fingers despite wrist immobilization 8. Your provider should have instructed you to actively move all fingers through full range of motion multiple times daily while keeping the wrist immobilized in the volar slab 1, 6.