Journal of Musculoskeletal Trauma

Original Article

Hook plate versus periarticular-type volar locking plate for distal radius fractures involving the volar lunate facet in Korea: a retrospective cohort study: Hyun-Jae Park, Joo-Hak Kim; J Musculoskelet Trauma 2025;38(4):221-228. Published online October 24, 2025; DOI: https://doi.org/10.12671/jmt.2025.00241

Background
This study investigated the clinical and radiographic outcomes of hook plate (HP) fixation for volar lunate facet fractures, comparing them with periarticular-type volar locking plates (PVLPs).
Methods
A retrospective review was conducted on 24 patients with distal radius fractures involving volar lunate facet fragments who underwent surgery between January 2016 and April 2021. Patients were divided into two groups: HP (n=12) and PVLP (n=12). Radiographic union, wrist range of motion, Disabilities of the Arm, Shoulder and Hand (DASH) scores, and implant-related complications were compared. Statistical analyses included the Mann-Whitney U test and Fisher exact test.
Results
Radiographic union was achieved in all patients (100%), without secondary displacement or hardware failure. No significant differences were observed between the two groups in wrist flexion (P=0.152), extension (P=0.832), pronation (P=0.792), or supination (P=0.328). The mean DASH scores were 12.8±5.5 in the HP group and 14.6±6.0 in the volar plate group (P=0.449). One patient in the HP group experienced mild flexor tendinopathy that resolved with conservative management. No cases of tendon rupture or early reoperation were reported.
Conclusions
Fixation of volar lunate facet fractures using a HP yielded clinical and radiographic outcomes comparable to those of PVLPs, with a low rate of complications and reliable bony union. Due to its mechanical stability, compatibility with standard surgical approaches, and low risk of flexor tendon irritation, the HP may serve as a valuable alternative for managing volar lunate facet fractures. Level of evidence: IV.

Citations

Citations to this article as recorded by

Open distal radius fracture with ulnar neurovascular injury treated with dorsal spanning plate fixation and vein interposition grafting: a case report
Kyeong-Eon Kim, Ho-Yong Lee, Shin-Woo Lee, Ji-Sup Kim
Journal of Musculoskeletal Trauma.2026; 39(3): 262. CrossRef

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Review Article

Surgical Treatment of Distal Radius Fractures and Treatment of Common Accompanying Lesions: Joo-Hak Kim; J Korean Fract Soc 2022;35(3):120-127. Published online July 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.3.120

Abstract PDF: There have been major advances in the treatment of distal radius fractures over the past 20 years. Specifically, the development of the volar locking plate in 2001 and the subsequent improvements in its design and performance have enabled the treatment of distal radius fractures that were previously considered difficult to treat. The volar plate is used for fractures and shows good results with anatomical reduction and firm fixation. However, when trying to apply it to more complex fractures, there are still difficulties related to the unique anatomical structure of the distal radius, and there are also several factors that can impair joint function and cause pain after surgery. In this review, the factors to be considered to ensure better outcomes during ORIF (open reduction and internal fixation), and external fixation in the treatment of distal radial fractures are described. The review also details the common accompanying injuries and management methods.

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