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Objective <p>To compare the clinical efficacy of a modified Henry approach (preserving the FCR tendon sheath) versus the traditional approach (incising the sheath) for distal radius fractures (DRFs) treated with volar locking plates, and to evaluate the outcomes within 12 months postoperatively.</p> Methods <p>A retrospective cohort study was conducted on 165 patients with unstable DRFs who underwent volar locking plate fixation from January 2023 to March 2025, who were retrospectively divided into the Preservation Group (<i>n</i> = 79, FCR tendon sheath preserved via the modified approach) and the Control Group (<i>n</i> = 86, FCR tendon sheath incised via the traditional approach). Perioperative indicators, radiological parameters, Visual Analog Scale (VAS) scores, Disabilities of the Arm, Shoulder and Hand (DASH) scores, grip strength, wrist range of motion (ROM) and complications were compared at the follow-up time points of 1 week, 1, 2, 3, 6 and 12 months postoperatively.</p> Results <p>There were no significant differences in baseline data and postoperative radiological reduction quality between the two groups (<i>P</i> &gt; 0.05). The Preservation Group had significantly lower VAS scores at all follow-up time points (<i>P</i> &lt; 0.001), and lower DASH scores from 1 week to 6 months (<i>P</i> &lt; 0.001), with no statistical difference at 12 months (<i>P</i> = 0.550). Grip strength of the Preservation Group was significantly superior at all time points from 1 month to 12 months (<i>P</i> &lt; 0.05), while wrist ROM was significantly better at 1 and 2 months (<i>P</i> &lt; 0.001), with no significant differences at 3, 6 and 12 months (<i>P</i> &gt; 0.05). The Preservation Group had a significantly lower incidence of tendon adhesion (2.5% vs. 11.6%, <i>P</i> &lt; 0.05) and overall complication rate (11.4% vs. 23.3%, <i>P</i> &lt; 0.05) than the Control Group. No radial artery injury or complex regional pain syndrome (CRPS) occurred in either group.</p> Conclusion <p>The modified Henry approach preserving the FCR tendon sheath significantly improves early postoperative pain relief and functional recovery, with sustained benefits in pain and grip strength up to 12 months. This technique does not increase surgical difficulty, reduces complication risk, and follows the ERAS principle, showing high clinical value.</p>

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Impact of modified Henry approach with preservation of Flexor Carpi Radialis Tendon Sheath on wrist function in the treatment of distal radius fractures

  • 期刊论文

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  • 发表日期：

    2026年5月15日

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  • Dang Ma,
  • Jiaqing Ji,
  • Yimin Zhu,
  • Xue Fang,
  • Yanben Wang,
  • Jian Fan

摘要

Objective

To compare the clinical efficacy of a modified Henry approach (preserving the FCR tendon sheath) versus the traditional approach (incising the sheath) for distal radius fractures (DRFs) treated with volar locking plates, and to evaluate the outcomes within 12 months postoperatively.

Methods

A retrospective cohort study was conducted on 165 patients with unstable DRFs who underwent volar locking plate fixation from January 2023 to March 2025, who were retrospectively divided into the Preservation Group (n = 79, FCR tendon sheath preserved via the modified approach) and the Control Group (n = 86, FCR tendon sheath incised via the traditional approach). Perioperative indicators, radiological parameters, Visual Analog Scale (VAS) scores, Disabilities of the Arm, Shoulder and Hand (DASH) scores, grip strength, wrist range of motion (ROM) and complications were compared at the follow-up time points of 1 week, 1, 2, 3, 6 and 12 months postoperatively.

Results

There were no significant differences in baseline data and postoperative radiological reduction quality between the two groups (P > 0.05). The Preservation Group had significantly lower VAS scores at all follow-up time points (P < 0.001), and lower DASH scores from 1 week to 6 months (P < 0.001), with no statistical difference at 12 months (P = 0.550). Grip strength of the Preservation Group was significantly superior at all time points from 1 month to 12 months (P < 0.05), while wrist ROM was significantly better at 1 and 2 months (P < 0.001), with no significant differences at 3, 6 and 12 months (P > 0.05). The Preservation Group had a significantly lower incidence of tendon adhesion (2.5% vs. 11.6%, P < 0.05) and overall complication rate (11.4% vs. 23.3%, P < 0.05) than the Control Group. No radial artery injury or complex regional pain syndrome (CRPS) occurred in either group.

Conclusion

The modified Henry approach preserving the FCR tendon sheath significantly improves early postoperative pain relief and functional recovery, with sustained benefits in pain and grip strength up to 12 months. This technique does not increase surgical difficulty, reduces complication risk, and follows the ERAS principle, showing high clinical value.