Distal Radius Fractures: What Cannot Be Fixed With a Volar Plate?—The Role of Fragment-Specific Fixation in Modern Fracture Treatment

The advent of volar fixed-angle plate osteosynthesis has greatly improved the technical ability of the surgeon to treat distal radius fractures and expanded the indications for operative treatment. Nevertheless, the volar plate is not a panacea for all distal radius fractures. Increasingly, it has been recognized that the loss of fixation, secondary displacement, and lack of stability can occur after volar fixed-angle plate osteosynthesis. This article addresses the treatment of distal radius fractures with complex disruption of the articular surface and the unique ability of fragment-specific fixation to achieve stable fixation of these injuries.