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Case Reports in Orthopedics
Volume 2017, Article ID 6269081, 5 pages
Case Report

Difficulty in Fixation of the Volar Lunate Facet Fragment in Distal Radius Fracture

1Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan
2Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
3Orthopaedic Trauma Center, Sapporo Tokushukai Hospital, Sapporo, Japan

Correspondence should be addressed to Tomonori Baba;

Received 13 November 2016; Accepted 18 January 2017; Published 31 January 2017

Academic Editor: Andreas Panagopoulos

Copyright © 2017 Hiroyuki Obata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Recent reports suggest the presence of a rare fracture type for which reduction and fixation cannot be achieved with volar locking plate (VLP). In particular, it is difficult to achieve reduction and fixation with volar lunate facet (VLF) fragments present on the volar ulnar aspect of the lunate facet, because of the anatomical structure and biomechanics in this region. Herein, we report two challenging cases of difficulty in fixation of the VLF fragment in distal radius fracture. For this fracture type, it is most important to identify the volar ulnar bone fragment before surgery; it may also be necessary to optimize distal placement of the VLP via a dual-window approach and to apply additional fixations, such as a small plate, anchor, and/or external fixation.