Distal Radius Fractures-Section I: Distal Radius: Dorsal Plate: Indications/Technique/Complications

Video Transcription

Video Summary

In this video, the speaker discusses when to choose a dorsal plate versus a volar plate for internal fixation in distal radius fractures. They mention that contraindications for dorsal plates include volar shear fractures and volar lip fractures, and that dorsal plates are less ideal for Smith fractures or flexion fractures. The speaker states that dorsal plates are superior for dorsal shear fractures, fractures requiring direct articular visualization and reduction, and die-punch fractures with depressed articular fragments. Dorsal plates are also recommended when there is a chance that a bridge plate may be needed. The speaker highlights the importance of CT scans in preoperative planning for fractures with unclear articular surfaces. They also mention other indications for dorsal plates, such as associated proximal pulse scaphoid fractures, suspected carpal ligament injuries, open fractures dorsally, and cases where combined fixation may be needed. The speaker provides a detailed description of the surgical technique for dorsal plating, including precautions and pearls. They also discuss the biomechanics and complications of dorsal plates, emphasizing that newer generation plates have lower complication rates compared to older plates. The speaker presents several case examples where dorsal plating was chosen based on the fracture characteristics and outcomes. In summary, the speaker concludes that while the majority of distal radius fractures are still plated volarly, dorsal plates have advantages in certain fracture types and can provide good outcomes with lower complication rates. The video references a study by David Ring and a technique paper by Kevin, both of which were published in the Journal of Hand Surgery. No other credits were mentioned in the transcript. The video provides valuable insights for surgeons considering dorsal plating in distal radius fractures.

Keywords

dorsal plate

volar plate

internal fixation

distal radius fractures

contraindications