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ecent emphasis in the literature has underscored the difficulty in managing this fracture fragment, suggesting standard volar plates may not be able to adequately stabilize the fragment. This article reviews the current literature with a special emphasis on fixation with a specifically designed fragment-specific hook plate to secure the lunate facet. Case Descriptiona? n extended flexor carpi radialis volar approach was made which allows access to the distal volar ulnar fracture fragment. Once provisionally stabilized with Kirschner wire fixation, a volar hook plate was applied to capture this fragment. Additional fracture stabilization was used as deemed necessary to stabilize the remaining distal radius fracture. Clinical Relevancea? he volar marginal rim fragment remains a challenge in distal radius fracture management. Use of a hook plate to address the volar ulnar corner allows for stable fixation without loss of reduction at intermediate-term follow-up. We present a rare case of unusual pattern of injury, involving dorsal dislocation of four ulnar carpometacarpal joints, associated with fracture of the trapezium, a burst fracture of the trapezoidA bone and an extra-articular fracture of the third distalA of the radius.

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