Distal Radius Fracture Treated with a Modified Kocher-style Dorsolateral Approach, Distal Radius T-plate, and Cannulated Compression Screw Fixation.
Navendu Dilip Gadhia, Abhijit More, Abhishek Nair
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Case in brief
A 45-year-old right-hand-dominant manual laborer presented with pain, swelling, and deformity after falling on an outstretched hand. Imaging showed a displaced extra-articular distal radius fracture with a large radial styloid/lateral fragment, little comminution, an intact ulna, and a congruent distal radioulnar joint. Through a modified Kocher-style dorsolateral approach, the fracture was reduced and fixed with a distal radius T-plate and a 3.0-mm cannulated compression screw. Alignment was maintained, union was seen at 3 months, and the patient returned to manual work. At 1 year he remained asymptomatic without reported complications.
What made this case unusual
The case demonstrates fragment-specific fixation through a dorsolateral approach for a radial styloid-dominant fracture, combining a T-plate buttress with a cannulated compression screw rather than using a standard volar exposure.
Diagnostic / clinical pearl
Fracture morphology matters: a large radial styloid/radial column fragment with limited comminution may permit direct fragment-specific compression and buttress fixation through a dorsolateral approach.
Why it matters
This single case describes a selected alternative to volar locking plating, not a replacement for it; the authors note that the single-case design and lack of prospectively recorded patient-reported outcomes limit generalizability.