Dorsal and volar plates for fractures and osteotomies of the distal radius. The plate should be placed slightly below the distal edge of the radius to support the volar articular fracture fragments and also to avoid. Read pdf dvr crosslock distal radius plating system surgical technique dvr crosslock distal radius plating system surgical technique recognizing the pretentiousness ways to get this book dvr crosslock distal radius plating system surgical technique is additionally useful. Surgical nonspanning fixator for distal radius fractures. Ten patients treated within one year for complex distal radius fractures by doubleplating technique with a radial buttress plate and volar locking plate, through a single volar approach, were followed prospectively. Jan 24, 2014 the following video demonstrates the surgical application of the a. Osteosynthesis variax distal radius locking plate system. Learn the radioscapholunate fusion using medartis plate with distal scaphoid excision surgical technique with step by step instructions on orthoracle. Volar distal radius locking plate that best accommodates patient anatomy and fracture pattern. Note the periloc volar distal radius plate preoperative templates 71180981, 71180982 are available to assist with preoperative radiographic planning. The aculoc ex plates provide an option for extraarticular fractures and osteotomies. The insertion of the brachioradialis may be released. Grabow hand to shoulder center medical professionals surgical assistants and technologists operative technique manuals operative technique manuals. The locking aculoc dorsal plates offer a solution to treat distal radius fractures that need to be addressed from the dorsal side.
Inclusion criteria included patient age of 18 to 89 years, a displaced andor unstable distal radius fracture requiring open reduction internal fixation, and a minimum final clinical and radiographic followup of 12 months. The illuminoss implant can be used for either the left or the right radius. Surgical techniques stepbystep installation methods. Few surgical approaches have been described that spare the pronator quadratus pq during the treatment of distal radius fractures.
An anatomic algorithm for surgical management, abstract most distal radius fractures result from lowenergy mechanisms and can be successfully treated nonsurgically or with a variety of surgical techniques if indicated. Volar carpal translation maneuver using the medartis distal radius plate dr david tuckman. The evolution of distal radius fracture management a. Operative technique manuals grabow hand to shoulder center. Written by one of the worlds foremost authorities, this beautifully illustrated surgical atlas is a casebased presentation of the management of distal radius fractures. Medartis ag hochbergerstrasse 60e 4057 baselswitzerland. Using zimmers anatomical database, the plate contour conforms to a broad range of patient anatomy and the. Fractures of the distal radius are the most common fractures in the human body. Hook plate accessory extends plate fixation capability to secure volar marginal fragments. The dorsal and radial cortices are thin and the volar and ulnar cortices are thick. Arthrex spanning plate for distal radius fractures. Medartis volar locking plating of distal radius fracture. Oct 19, 2016 the purpose of this study was to demonstrate our surgical strategy and technique of dlps for displaced distal radius fractures according to the fracture patterns.
All fractures were treated with the aptus distal radius 2. The variax 2 distal radius plating system provides you with a comprehensive range of anatomic plating options that work with a common instrument and screw platform. Up to three screws capture and stabilize even distal fragments. Trilock multidirectional angular stability of 15 in all directions in each screw hole.
Anatomical plate design, easily contourable to provide the desired fit. For fragmentspecific fracture fixation with variable angle locking technology. Surgical strategy and techniques for lowprofile dorsal. To determine which plate to use, measure distally from the dorsal rim of the distal radius to the mcp joint. Traditional percutaneous kirschner wires kwire and open reduction with volar locking plate vlp are the two most common surgical fixation techniques used to manage dddrf. Double shaft design provides high rotational stability. The arthrex titanium volar distal radius plating system provides a comprehensive solution for distal radius fracture management.
Plates utilize smartlock technology which permits polyaxial screw placement. Technique fixed angle fixation of distal radius fractures. Distal radius fractures have been a common affliction for millennia, but their treatment is a more recent development as a result of human erudition. Juxtaarticular plates may be used for more complex fractures ao types b3, and c1c3. Operative technique choose the appropriate implant according to patient anatomy and fracture pattern. The aculoc vdu plates are designed specifically for periarticular fractures of the distal ulna. Biological sciences fractures care and treatment fractures injuries internal fixation comparative analysis internal fixation in fractures. Background the lowprofile dorsal locking plating dlp technique is useful for treating dorsally comminuted intraarticular distal radius fractures.
Report by bosnian journal of basic medical sciences. A proprietary 8mm slot that provides two differentiating. While the volar approach is by far the preferred approach when fixing most distal radius fractures the dorsal approach is necessary is certain fracture patterns. Trilock variable angle of 15 in all directions in each screw hole. The distal radius has metaphyseal flare and three articular surfaces. Aug 11, 2010 a possible difficulty in intraarticular fracture of the distal radius is the displacement tendency of the radial styloid process due to the tension of the brachioradialis tendon. However, there is no current consensual evidence to guide the selection of one technique over the other. Is minimally invasive application by intramedullary osteosynthesis in comparison with volar plating real benefit in the treatment of distal radius fractures.
Metaanalysis for dorsally displaced distal radius fracture. Available in narrow, standard and wide options in varying lengths from 53mm to 200mm. Repositioning and stabilization of the radial styloid process. A comprehensive offering of volar plates are available in narrow, standard, and wide as well as. Atraumatic screw options for every indication and surgeon preference. Lee, md, new york, ny presents the arthrex volar distal radius plate technique. Surgical technique metacarpal pin placement pins with a 15mm thread length are provided for use in the metacarpal. Surgical management of distal end radius fractures by various. Volar distal radius locking plate surgical devices and. Patented hexadrive screw head design for increased torque transmission with simplified screw pickup due to patented selfholding technology. Arthrex distal radius surgical stabilization with the wrist. Arthrex distal radius plate surgical technique youtube. Together with leading surgeons medartis has developed the unique aptus hand fixation system for the management of fractures and arthrodeses of the phalanges and metacarpals. Common types of distal radius fractures everything you need to know dr.
The titanium volar plates are available in a wide array of sizes narrow, standard, and wide and in. Anatomical plate designs for simple intraoperative use. Distal radius sterile kit surgical technique depuy synthes 1 sterile tube packaging the screws contained in the distal radius sterile kit were selected based upon the wide anatomical range they can cover and historical saleusage data to maximize the breadth of surgeries in which they can be used. Open the extensor retinaculum performing a longitudinal incision between the first and second extensor compartments. Orthopaedic surgery atlas of distal radius fractures. The pq supplies blood to the distal radial epiphysis, helps stabilize the distal radioulnar joint, and contributes 21% of pronation strength. Orthopaedic surgerydistal radius fractures wikibooks, open.
While immobilization has served as the only available treatment for most of our history, many advances. While classification systems abound and eponyms linger in common parlance, neither descriptive system really provides suitable common ground for communication as to the particulars of these fractures. Rounded edges and a smooth surface for soft tissue protection. Radioscapholunate fusion using medartis plate with distal. The titanium wrist plating system is designed for fixation of intraarticular and extraarticular fractures, osteotomies, and nonunions and malunions of the distal radius. We showed our dlp techniques based on fracture patterns to obtain accurate correction and rigid fixation and avoid extensor tendon irritations, using our original dorsal soft tissue.
Preangled trilock holes for oriented screw placement specially for the radial styloid. A comprehensive offering of volar plates are available in narrow, standard, and wide as well as multiple shaft lengths. Fixation of unstable distal radius fractures full text view. Instruments and implants approved by the ao foundation. Lcp wrist fusion set surgical technique depuy synthes 7 1 approach place the patient in the supine position with the hand and arm on a hand table. Variable angle lcp twocolumn volar distal radius plate 2. All operations include detailed step by step instruction, expert commentary and operation specific certificated cpdcme modules. Pdf recently, many studies have emphasized the importance of the comprehension of detailed functional anatomy of the distal forearm and wrist joint. In order to meet the requirements of the delicate structures of the hand, the various plate designs are optimally adapted to the bone geometry. Each chapter offers a comprehensive guide to the diagnosis and treatment of a specific fracture, including possible complications and how to prevent them, using detailed. Surgical approach and reductionfixation method were taken under the. Surgical technique this publication is not intended for distribution in the usa. You have remained in right site to start getting this info. Dorsal approach and plating of a distal radius fracture.
The aim of this report was to provide an update on the existing surgical solutions for the management of these fractures and describe details of the surgical technique applicable to these injuries. Open the third dorsal compartment, and transpose the ex. Christoph ranft, kiel, germany clinical case step 1 step 2a radiograph of a type c3. Orbay, md, amel touhami, md, and carolina orbay miami hand center, miami, florida n abstract treating unstable distal radius fractures in osteoporotic patients remains a challenge for the surgeon. However, recent detailed evaluation of fracture patterns and results of treatment have demonstrated the need for surgical intervention.
We detail this surgical technique with clinical and radiological outcome of treated patients. Dvr crosslock distal radius plating system surgical technique. The integrity of the scapholunate ligament is not important, as the capitate is unable to migrate proximally once the lunate is fused into the lunate fossa of the distal radius. Jul 15, 2015 dorsally displaced distal radius fractures dddrf are frequent injuries in clinical practice. This publication is not intended for distribution in the usa. Prospective evaluation of distal radius fractures treated.
Expert consult online and print, 1e provides beautiful handdrawn anatomic images along with clear instructions on the performance of each operation. Fixed angle fixation of distal radius fractures through a minimally invasive approach jorge l. This document is intended as an outline for the surgical technique of the repair of the distal radius. The optimal management of fractures of distal end radius has changed dramatically. Variax distal radius locking plate system this publication sets forth detailed recommended procedures for using stryker osteosynthesis devices and instruments. Contemporary perspectives in distal radius fracture. Volar and dorsal plates for fusion of radius, scaphoid and lunate rsl physiological motion in the midcarpal joint is maintained. Geminus volar distal radius plate skeletal dynamics. Volar approach to dorsally displaced distal radius fractures a volar plate with locked fixation provides balanced stable fixation of the distal fragments. Surgical technique product information table of contents the 2. Volar carpal translation maneuver using the medartis. Distal radius surgical stabilization with the wrist plating system. Arthrex arthrex distal radius plate surgical technique. In recent years, great changes have taken place both in the treatment options of the distal radius and the patient demands which have increased.
The purpose of this study is to report the outcomes of a cohort of patients who underwent corrective osteotomy of the distal radius using a volar locking plate. Surgical cpx, nonspanning fixator for the treatment of distal radius fractures. In addition, all relevant information can be found on the internet at. Instructions for use for medartis aptus indications plates. Prerequisites for this procedure are that neighboring joints are free of disease radioscaphoid and midcarpal joint. Corrective osteotomy for deformity of the distal radius. Fractures of the distal radius are extremely common and majorities are well treated non operatively. Made of titanium alloy ti6al4v and treated with a type ii anodization, these plates are able to carry the loads that are required of them while remaining low profile. This paperback book stresses the most basic aspects of surgical technique in terms of how a surgeon interacts with with the human body as heshe performs the surgical procedure. In this report on singleapproach radiovolar plating, we describe a simple technique to overcome the dislocation tendency of the radial styloid process and ease anatomic reduction. Unstable distal radius fractures require surgical fixation of the broken bone because closed reduction nonsurgical manipulation of the fractured bones and casting often is not sufficient to maintain fracture reduction and promote bone healing. Initial kwire placement can be done with a traditional crosspinning technique. It offers guidance that you should heed, but as with any such technical guide, each surgeon must consider the particular needs of each patient and make appropriate adjustments.
The drill guide blocks are adapted to the distal area of hte patl es a 47506. Volar distal radius plate preoperative templates cat. Is minimally invasive application by intramedullary. The length of the radius portion of both aculoc wrist spanning plates is 100 mm. The resulting peripheral configuration of kwires should leave the center of the distal radius free for eventual placement of the conventus cage dr, as shown in the diagram to the left. Two plate lengths to address fractures of the ulnar head, neck and the distal shaft. A fracture of the distal radius is the most common fracture referred for orthopedic consultation from the emergency room.