Plating of the distal radius

J Am Acad Orthop Surg. 2005 May-Jun;13(3):159-71. doi: 10.5435/00124635-200505000-00003.


Distal radius fractures are common injuries that can be treated by a variety of methods. Restoration of the distal radius anatomy within established guidelines yields the best short- and long-term results. Guidelines for acceptable reduction are (1) radial shortening < 5 mm, (2) radial inclination > 15 degrees , (3) sagittal tilt on lateral projection between 15 degrees dorsal tilt and 20 degrees volar tilt, (4) intra-articular step-off < 2 mm of the radiocarpal joint, and (5) articular incongruity < 2 mm of the sigmoid notch of the distal radius. Treatment options range from closed reduction and immobilization to open reduction with plates and screws; options are differentiated based on their ability to reinforce and stabilize the three columns of the distal radius and ulna. Plating allows direct restoration of the anatomy, stable internal fixation, a decreased period of immobilization, and early return of wrist function. Buttress plates reduce and stabilize vertical shear intra-articular fractures through an antiglide effect, where-as conventional and locking plates address metaphyseal comminution and/or preserve articular congruity/reduction. With conventional and locking plates, intra-articular fractures are directly reduced; with buttress plates, the plate itself helps reduce the intra-articular fracture. Complications associated with plating include tendon irritation or rupture and the need for plate removal.

Publication types

  • Review

MeSH terms

  • Bone Plates* / adverse effects
  • Bone Plates* / classification
  • Bone Screws
  • Equipment Design
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods
  • Humans
  • Radius Fractures / classification
  • Radius Fractures / surgery*
  • Treatment Outcome