Objective To compare the palmar minimally invasive approach by a single incision versus palmar traditional approach for implantation of a locking plate in the treatment of distal radius frac-tures.Methods A retrospective analysis was conducted of the 116 patients with distal radius fracture who had been treated with locking plates implanted through a palmar approach at Department of Traumatic Ortho-pedics,Wuxi Ninth People's Hospital from January 2019 to December 2022.There were 51 males and 65 females aged(57.0±10.6)years.According to the difference in palmar approach,they were divided into a traditional group of 65 cases treated with a traditional palmar approach and a minimally invasive group of 51 cases treated with a minimally invasive palmar approach through a single 1.5 cm incision.The surgical time,intraoperative bleeding,incision length,incision healing,fracture healing time,pain visual analogue scale(VAS)on the 1st and 7th days after surgery,range of motion and grip strength of the affected wrist,and imag-ing results at the last follow-up were recorded and compared between the 2 groups.The patient rated wrist eval-uation(PRWE)and Gartland-Werley wrist evaluation were used to assess functional recovery of the wrist affect-ed at the last follow-up.Results There was no statistically significant difference in the baseline data be-tween the 2 groups,indicating comparability(P＞0.05).All patients were followed-up for(13.6±2.1)months.All fractures healed.The intraoperative bleeding[(27.3±3.6)mL]in the minimally invasive group was significantly less than that in the traditional group[(41.2±6.8)mL],the incision length[(1.6±0.1)cm]in the former was significantly shorter than that in latter[(6.6±0.6)cm],the post-operative VAS for pain on the 7th day after surgery[(1.8±0.8)points]and incidence of complications[2.0％(1/51)]in the former were significantly lower than those in the latter[(3.0±0.6)points,12.3％(8/65)](P＜0.05).However,the surgical time[(70.4±6.9)min]in the former was sig-nificantly longer than that in the latter[(67.2±8.0)min](P＜0.05).There was no statistically signif-icant difference between the 2 groups in terms of incision healing,fracture healing time,VAS for pain on the first postoperative day,wrist range of movement at the last follow-up,grip strength,PRWE score,Gartland-Werley functional recovery,fracture alignment,palm angle,ulnar deviation angle,and radial height at the last follow-up(P＞0.05).Conclusions Both the palmar minimally invasive approach by a single inci-sion and the traditional palmar approach are effective for implantation of a locking plate in the treatment of distal radius fractures.However,the minimally invasive palmar approach is superior to the traditional palmar approach in terms of incision aesthetics,intraoperative bleeding,surgical trauma response,surgical time and surgical risk.
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