Distractor-assisted Reduction for Volar Shear Distal Radius Fractures: A Retrospective Case Series.

Abstract

Volar shear distal radius fractures are technically challenging due to the difficulty in controlling small volar fragments. This study aimed to evaluate the clinical and radiographic outcomes of a distractor-assisted reduction technique in the surgical management of these fractures. We retrospectively reviewed 23 consecutive patients treated with distractor-assisted reduction and volar plating between January 2024 and March 2025. Radiographic outcomes (ie, radial height, inclination, volar tilt) and functional outcomes, including wrist range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Modified Mayo Wrist Score (MMWS), were assessed. A total of 23 patients completed follow-up at a mean of 13.4 months. Radiographic alignment was well restored, with a mean radial height of 11.6 ± 1.8 mm, radial inclination of 22.4° ± 3.1°, and volar tilt of 11.2° ± 3.6°. Wrist motion recovered satisfactorily, with mean wrist extension of 64° ± 11° and flexion of 71° ± 12°. The mean DASH score was 12.8 ± 7.4. According to the MMWS, outcomes were rated as excellent in 15 patients, good in 7, and fair in 1. Grip strength recovered to 83% ± 9% of the contralateral side. No major complications were observed. Distractor-assisted reduction appears to be a useful adjunct in the surgical treatment of volar shear distal radius fractures.