Although distal radius fractures drf are common fractures, intraarticular comminuted drf with volar free fragments are uncommon. Distal radius fracture distal radius fracture repair with volar plate dupuytrens disease finger felon drainage finger fracture fixation flexor tendon injuries finger joint fusion dip joint fractures of the finger fractures of the hand ganglion cysts of the hand ganglion cyst removal kienbocks disease mallet finger open carpal tunnel release. Fixation loss can occur in a number of ways, including radial shortening of the distal fragment, increasing dorsal angulation, and loss of. Dorsal plate fixation is an important and useful treatment strategy for certain types of distal radius fractures. The top countries of suppliers are india, china, and india, from which the percentage of distal radius locking plate supply is. Intermediate column fractures icf of the distal radius are fractures only or mainly limited to the middle column of the distal radius that is a result of an axial load passed to the lunate fossa. Md uses the acumed aculoc 2 wrist plating system to treat a 63yearold female who presented with a chronic malunion of the distal radius from a fracture treated nonoperatively five years earlier. The acumed aculoc 2 wrist plating system offers 48 plate options including distal and proximal sitting plates, three different plate extension options, and fragmentspecific plating choices. A recent prospective study on the national incidence of osteoporosisassociated fractures in. Distal radius fractures are most often caused by falling onto an outstretched hand. Contrary to general belief, arthroscopic assisted reduction in distal radius. The acumed aculoc extraarticular plate is designed for extraarticular distal radius fractures and osteotomies. The radius is the forearm bone on the thumb side in the xray above, it is the one on the right.
Guide insert with the square driver after checking the drilled depth figure 18. Functional outcome in distal radius fractures treated with locking. Volar plating in distal end radius fractures and its clinical and. Prep hand, and apply finger trap traction if desired. Suggested operative fixation for fractures with postreduction radial shortening 3mm, dorsal tilt. 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. One study found that only 2 9% of collesfound that only 2. Variable angle lcp twocolumn volar distal radius plate 2. Features and benefits oblong combihole allows accurate plate positioning on the bone dedicated screws. Smith described fracture of distal radius with forward displacement. Distal radius fracture is the most common fracture of the upper extremity, with an annual incidence of 2 to 4 per 1,000 persons. Mar, 2009 thirteen cases of complete tendon rupture after volar plate fixation of distal radius fractures have been reported in the literature to date, 5, 10.
Korean type distal radius anatomical volar plate system. Distal radius fractures are one of the most common orthopedic injuries and appear in various patterns. The system also features innovative instrumentation for fracture management and plate positioning. The record is updated if the fda identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Korean type distal radius anatomical volar plate system clinics in orthopedic surgery vol. Risk factors for complications after volar plate fixation of distal radial. Keywords distal radial fractures, radius fractures, locking plate.
Distal radius fractures represent approximately one sixth20% of all fractures distal radius fractures occur through the distal metaphysis of the radius may involve articular surface frequently involves the ulnar styloid 4. Lee, md, new york, ny presents the arthrex volar distal radius plate technique. A comprehensive offering of volar plates are available in narrow, standard, and. The distal radius plate is indicated for the osteopenic and periarticular fractures, revision surgery of pseudarthrosis, nonunion and malunion, arthrodesis and ligament reattachment, fixation of complex intra and extraarticular fractures and osteotomies of distal radius. However, income and articular incongruities, but not motion, were significant predictors of the michigan hand questionnaire in younger patients 17. Narrow head plates available in 2 sizes, standardhead plates available in 3 sizes and wide head plates available in 1 size. The implants of the initial r range are intended for the fixation of intra and extraarticular fractures as well as.
Osteosynthesis variax distal radius locking plate system. Bartons fracture an intraarticular fracture of the distal radius with dislocation of the radiocarpal joint. Distal plate placement volar joint line fibrous transition zone. The use of dorsal plating has largely fallen out of favor due to the high rates of extensor tendon complications associated with first generation dorsal plates. Using the same driver, fill the holes in the head of. Dorsal access for radius plate dorsally, create a longitudinal incision over the distal radius, between the 2nd and 3rd dorsal extensor tendon compartment. Treating a distal radius fracture using spanning plate fixation. Distal radius anatomy applied to the treatment of wrist fractures by plate. Thirteen cases of complete tendon rupture after volar plate fixation of distal radius fractures have been reported in the literature to date, 5, 10. Volar distal radius plate preoperative templates cat. To further assist with complications of wrist fractures, osteotomies, and other wrist injuries, acumed has introduced three additional plate families to the system. There are almost 600,000 distal radius fractures per year in the united states, so you are not alone. Distal radius plate of cfrpeek has minimal effect compared to. The insertion of the brachioradialis may be released.
Distal radius plate and lcp the locking plate has changed the way to treat distal radial fractures 40. Proximal row of the head of the plate remove each f. Flexor tendon problems after volar plate fixation of distal. Optimized plate design allows for ideal support of the radial and intermediate distal radius columns. Dorsal plate fixation for distal radius fractures springerlink. Therefore, implants made out of cfrpeek allow metalartifactfree postoperative monitoring by computed tomography ct, magnetic.
The acumed anatomic radial head system is designed to provide an 2 mini and micro instruments and the locking radial. Volar plating of distal radius fractures operative technique a reduce the fracture before placing the plate. Dtdvps2 polyaxial plate for distal radius standard head size 2 right dtgvps2 polyaxial plate for distal radius standard head size 2 left. In order to prevent toggling, this drill guide is designed to fit very tightly into the holes of the plate. Fractures of the distal radius drf are commonly defined as fractures within three centimeters of the radiocarpal joint of the radius, where the lower end of the radius interfaces with the carpal bones 21. Primary volar plate fixation of unstable distal radius fracture provides a stable construct that helps in early mobilization, thereby. A comprehensive offering of volar plates are available in narrow, standard, and wide as well as multiple shaft lengths. Cases included illustrate the various uses of the volar locking plate for. Metaanalysis for dorsally displaced distal radius fracture. Arthroscopic reduction and internal fixation of distal radius. The plate should be placed slightly below the distal edge of the radius to support the volar articular fracture.
It can also be used in conjunction with the acumed forearm rod system for a less invasive approach to bothbone fractures of the diaphyseal region. Loss of fixation in distal radius fractures springerlink. Volar locking plate fixation may be used for both volarly and dorsally displaced fractures and provides fracture stability under axial loads encountered during early postoperative mobilisation despite the fixation being on the tension side of the fracture complex 7, 15, 18, 21, 26, 27, 37. The plates are anatomically contoured to match the anatomy of the distal radius, and are designed to address both simple and complex fractures. Some have been attributed to plate or screw design, chronic steroid use, fracture collapse, suboptimal placement 1, 3, or incorrect plate usage. The top countries of suppliers are india, china, and india, from which the percentage of distal radius locking plate supply is 17%, 76%, and 17% respectively. Acumed distal radius plate pdf in, acumed introduced the aculoc targeted volar distal radius plate system for acumed aculoc wrist plating system surgical technique. Distal radius fixation with volar locking plate by a minimally invasive. Distal radius fractures represent approximately one sixth20% of all fractures distal radius fractures occur through the distal metaphysis of the radius may involve articular surface. Dec 01, 2015 smith described fracture of distal radius with forward displacement.
Perform a longitudinal incision between the 1st and 2nd extensor tendon compartment to expose the extensor. Internal fixation plates for distal radius fractures. Distal end of radius part ii evidence based jbjs 93a d number 8 d april 20, 2011, 776 1. Volar locking plate fixation of distal radius fractures. Percutaneous k wire vs volar plate j bone joint surg am. External fixation vs volar plate j bone joint surg am.
Lauder a, agnew s, karim b, allan c, hanel d, huang j functional outcomes following bridge plate fixation for distal radius fractures. Jul 15, 2015 dorsally displaced distal radius fractures dddrf are frequent injuries in clinical practice. Single use distal radius sterile kit initial r kits content indications. Acumed aculoc 2 volar distal radius plating system. Juxtaarticular plate fixation in distal radius intraarticular. Distal radius fractures what is a distal radius fracture and how does it happen. Distal radius fractures a clinical casebook jeffrey n.
Flexor tendon problems after volar plate fixation of. Article information, pdf download for risk factors for complications after volar. Acumed aculoc 2 standard volar distal radius plates have an optimized design to closely replicate the. Management of free osteochondral fragments according to the. Biomechanical analysis of volar and dorsal double locking.
Apr 22, 2016 distal radius plate and lcp the locking plate has changed the way to treat distal radial fractures 40. Firstgeneration dorsal plate designs were a logical solution but were fraught with complications secondary to tendon. Make an incision using the flexor carpi radialis fcr approach, with distal extension as necessary. Rashard dacus, demonstrates a technique for distal radius fracture fixation using a tplate. For fragmentspecific fracture fixation with variable angle locking technology.
Case 2 comminuted, dorsallydisplaced fracture of the distal radius. Loss of fixation is one subset of complications that may be encountered after surgical treatment for distal radius fractures. Surgical technique this publication is not intended for distribution in the usa. A metal plate shaped to fit the contours of the radius is inserted and positioned against the bone. Evidence based postoperative treatment of distal radius. Purpose the purpose of this study distak to evaluate the radiographic and clinical outcomes of the fragloc compression screw with plae plate fixation on distal radius fractures that include a displaced dorsoulnar fragment. Instruments and implants approved by the ao foundation. Hand and wrist distal radius plates 459 head holes small tplates ii 34 head holes oblique radius tplate ii ulna radius lclcp plate 3. Comprehensive plating system providing anatomical volar and dorsal, universal volar and fragment. Keywords distal radius, volar locking plate, dorsal screw protrusion, carpal shoot.
Place patient in supine position with hand extended on arm board. Barton, colles fracture, distal radius fracture, volar, volar barton. Arthrex arthrex distal radius plate surgical technique. In the context of the radius bone, a ray can be thought of rotating around an axis line extending diagonally clarification needed from center of capitulum to the center of distal ulna. Verify proper placement of screwspegs by use of fluoroscopy to ensure that neither penetrate the joint. Dorsally displaced distal radius fractures dddrf are frequent injuries in clinical practice. The variax distal radius plating system represents the next generation of bone fixation for your distal radius fracture needs. Using selfdrilling screws in volar plate osteosynthesis for distal. You might also hear this called a colles fracture, after abraham colles, who described it, but this term is not used by current researchers in the field. Displaced distal radius fractures are commonly fixed with volar locking plates 5, 9, 34. Aculoc 2 volar distal radius plating system surgical. Place locking or nonlocking screws in the proximal end of the plate.
The acumed system was the first elbow plating system to offer precontoured, parallel distal humerus plates. Distal radius fractures are one of the most common injuries encountered in orthopedic practice. The plate sits more proximally than the standard aculoc volar distal radius plate, and its distal locking screws are angled to support the dorsal lip of the radius, maximizing purchase in the subchondral bone. The anatomic midshaft forearm plating system includes midshaft ulna plates, volar midshaft plates, and dorsolateral midshaft radius plates. Acumed has introduced the aculoc 2 volar distal radius vdr plating system as the next generation in plating fixation. A wide variety of distal radius locking plate options are available to you, there are 812 suppliers who sells distal radius locking plate on, mainly located in asia. Small distal radius y plates dorsal product products. However, there is no current consensual evidence to guide the selection of one technique over the other. Complication rate comparing variable angle distal locking plate to fixed angle plate fixation of distal radius fractures. Note the periloc volar distal radius plate preoperative templates 71180981, 71180982 are available to assist with preoperative radiographic planning.
The implants of the alians radius range are intended for the fixation of extra and intraarticular fractures as well as distal radius osteotomies in adults. Long screws in the lateral column plate are designed to interdigitate with screws from the medial column plate, providing a parallel construct for the stabilization of distal humerus fractures. Volar distal radius locking plate that best accommodates patient anatomy and fracture pattern. Distal radius fracture repair with volar plate central. Alians distal radius range right plates green anodized dtdvpn2 20. Pdf volar plate fixation of distal radius fractures. The aculoc 2 proximal vdr plate family was designed to provide maximum support for the articular surface from a more proximal placement. Symptomatic extensor tendon irritation is a frequent complication in volar plate osteosynthesis of distal radius fractures. We aimed to evaluate the results of volar locking and unlocking plate fixation of adult distal radius fractures. Dtdvps1 polyaxial plate for distal radius standard head size 1 right dtgvps1 polyaxial plate for distal radius standard head size 1. Distal radius fractures most common ue fx 1 out of 6 fractures seen in er 3rd most common fracture high morbidity rate.
Based exclusively upon clinical cases covering fractures of the distal radius, this. The arthrex distal radius dorsal plate allows direct buttressing of dorsal comminution while keeping a low profile repair to reduce extensor tendon irritation. Annals of plastic surgery, 2016, dec, volume 77, number 4, pages 623625. Manufacturer of radius ulna plates lcp distal radius system 2. Choose the appropriate implant according to patient anatomy and fracture pattern. The radius is the larger of two long bones in your forearm. Corporate web site plate screw fixator implant bone nail prosthesis. A recent prospective study on the national incidence of osteoporosisassociated fractures in a population of more than. Screws are used to anchor the plate to the bone, stabilizing the radius. Detecting dorsal screw penetration following volar plate fixation of.
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