A 55-year-old woman with osteoporotic bone sustains a comminuted intra-articular distal radius fracture (AO type C3). Which implant provides the most stable fixation and allows early wrist mobilisation in this scenario?

• A Volar locked plating with locking screws in the distal fragment ✓
• B Dorsal buttress plating with conventional screws
• C External fixator with ligamentotaxis alone
• D Kirschner wire fixation with above-elbow backslab

Explanation

Volar locked plating (e.g., DVR plate, Variable Angle LCP) is the current gold standard for unstable and comminuted intra-articular distal radius fractures, particularly in osteoporotic bone. The locking screws achieve fixed-angle stability within the hard subchondral bone of the distal fragment, resisting secondary collapse and allowing early finger and wrist mobilisation. Dorsal plating risks extensor tendon irritation/rupture. External fixator via ligamentotaxis alone fails to restore intra-articular congruence in C3 fractures. K-wire fixation is inadequate for comminuted intra-articular patterns.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.