Comparison of Volar and Dorsal approaches for surgical treatment in fracture of proximal half of the radius

Objective: Fracture of the proximal half of the radius shaft can be exposed by either one of volar or dorsal approaches. The aim of this study was to compare the results of volar and dorsal approach for surgical treatment of proximal half fracture of the radius.

Methodology: This prospective study was performed from April 2008 to March 2012 in two teaching hospitals. Seventy adults patients with closed fracture in proximal half of the radius or radius and ulna were operated on and fixed using small plate and screw by volar approach (VA) (39 patients) and dorsal approach (DA) (31 patients). Comparison of the results in both surgical approach were the primary measurement outcome. Duration and time of procedure, rate and time of fracture union and motion of the forearm were assessed at 4 months after operation.

Results: Mean age of the patients with VA and DA was 25.3 and 26.5 years respectively. There was 26 male and 13 female in VD and 22 male and 9 female in DA patients. Radial nerve injury in VA and DA occurred in three and two patients, infection in one and nonunion in one other patient was seen in each group. There was no significant difference in duration of procedure or time of union after both approaches =0.643. Mean rotation of forearm was 135 deg. in VA, and 138 deg. in DA patients at 4 months post surgery.

Conclusion: There was no significant difference in term of fracture union, early complications, and range of forearm rotation between volar and dorsal approach for the fixation of radius fractures in its proximal half.