using a plate as a distraction method bridging the comminution to restore anatomical parameters to treat comminuted distal radius fracture follow-up functional outcomes of the wrist after metal removal

The plate is extended from the floor of the 2end extensor compartment at an intact radius to the 2end metacarpal by dual minimally invasive skin incisions.

One distal over 2end metacarpal and Other proximal over 2end extensor compartment at intact radius application of distal screws 1st, then the traction is done to restore radial length, radial inclination, and volar tilt followed by the application of proximal screws add wires to restore the joint congruity wire removal after 45 days, plate removal after 100 day follow up every 3 months till 1 year post-operative Assess the Functional Outcome Of the wrist joint after metal removal

Inclusion Criteria:

1. Skeletally mature patients
2. presented with multifragmentary distal radius fractures classify type 23-3C according to AO classification
3. articular with or without metaphyseal comminution
4. Very distal fractures 5 )osteoporotic bone fractures

Exclusion Criteria:

1. Dorsal soft tissue defect or tendon injuries
2. Metacarpal fractures (esp 2end MC)
3. open grade 3 fractures

oFirst peak is the young exposed to high energy trauma , fall from a height, polytrauma patients with extensive communition of metaphyseal and articular parts oSecond peak is old (over 60 years),with osteoporotic bone where even minor falls can cause extensive comminution