Dvr crosslock distal radius plating system surgical technique. Six months after a conservatively treated distal radius fracture the mean arc of flexion and extension and the forearm rotation were know to be 75% to 97% and 87 to 97%, respectively, compared with the uninjured side 610. The variax distal radius plating system represents the next generation of bone fixation for your distal radius fracture needs. Distal radius fractures are among the most common fractures seen in the. Treatment of distal radius fractures with volar locking.
Anterior fixed angle plate fixation of unstable distal radius fractures. The exhibit depicts open surgery to treat a fractured left radius. Juxtaarticular plates may be used for more complex fractures ao types b3, and c1c3. Because of their fracture bridging properties these systems offer an. As the incidence of distal radius fractures increases, so too does the importance of this classic volume. The distal radius fracture drf is an injury that predates our species, with a significant milestone in our evolution being the transition to bipedal ambulation by australopithecus. A leading variable angle system 6 plates per type were mounted according to ifu on osteoporotic cadaveric specimens matched for bone mineral density and shape. Winstar distal radius plates the winstar system consists of several plates with anatomically correct shape for reconstruction of the palmar tilt, taking into account the watershed line. The pq muscle is frequently avulsed from its distal attachment to the tfz. Distal radius fracture is a common trauma in the elderly because of the high frequency of osteoporosis in this age group. Zip file 351 kb unstable extraarticular fractures of the distal radius. Volar plate position and flexor tendon rupture following. Clinical function and outcome do not appear to be associated with repair of a fracture of the base of the ulnar styloid. In their paper, they also attempted to associate soong grade with tendon rupture risk, but their conclusions were limited by.
If you do not have it you can download adobe reader free of charge. All fractures were treated with the aptus distal radius 2. It is most likely caused by distal screws protruding the dorsal cortex. Tangential views of the articular surface of the distal. The distal radius plates unique distal articular plate arms. The wrist spanning plate is designed for distal radius fractures with severe comminution requiring prolonged fixation, as an alternative to external fixation. The treatment decision of a distal radius fracture is complex and depends on the type of the fracture, the age and activeness of the patient and the quality of the bone.
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. Dec 18, 2012 distal radius fractures drf are one of the most common fractures and often need surgical treatment, which has been validated through biomechanical tests. These files will have pdf in brackets along with the filesize of the download. In general among hand and forearm fractures, fractures of the distal radius comprise the largest portion 44 percent. 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. An overview article pdf available in journal of family medicine and primary care 34. Distal radius fractures are a common fracture of the arm, with a bimodal peak incidence between the second and third decade and individuals above 65 years of age.
The purpose of the present study was to assess the inter and intraobserver reliability of the soong classification system for volar plate position. The titanium plates had a length of 54 mm and a thickness of 2 mm. Distal radius fractures have been a common affliction for millennia, but their treatment is a more recent development as a result of human erudition. Dorsal plates for fractures that cannot be addressed with a volar plate. Xl plates for fixation of combined diaphysealmetaphyseal radius fractures. The influence of bone density and anisotropy in finite. Variations of plate shapes include h frame, straight, t and l shaped. Nathan edwin lesley, 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. Shorter distal screws could avoid this, yet the influence of distal screw length on the primary stability in vlpo is unknown. The mechanism of injury may be due to lowenergy falls, especially in women with osteoporosis, or highenergy trauma that occurs during sports or motor vehicle accidents.
Variax distal radius locking plate system this publication sets forth detailed recommended procedures for using stryker osteosynthesis devices and instruments. Distal radius fractures open reduction internal fixation case presentation and surgical technique. The distal radius reconstruction plate system is used for fixation of fractures of the distal radius and for corrective osteotomies of the distal radius with palmar or dorsal surgical access. Medartis, aptus, modus, trilock, hexadrive and speedtip are registered trademarks of. Minimally invasive hardware removal after minimally invasive distal radius plate osteosynthesis mipo. They are most commonly seen in patients in the third and fourth decades of life at the metaphysealepiphyseal junction. Distal and proximal preloaded drill guides standard 4hole atraumatic screw tips protect extensor tendons key sizes available in 1mm increments optional hook plate extension for volar marginal fragment cannulated polyaxial locking screw hook plate extension a. This study aimed to describe the intraosseous blood supply of the distal radius and its clinical implications in distal radius fractures. The treatment of distal radius fractures with volar locking plates is the only treatment currently available that allows immediate postoperative wrist motion without the need for additional fixation in most cases. Currently a number of different fracture models are used, none of which resemble the in vivo fracture location. Jan 10, 2015 introduction distal radius fracture represent approximately one sixth of all fractures there are three main peaks of fracture distribution,children aged 514 years,male aged under 50 years and females over the age of 40 years distal radius fractures occur through the distal metaphysis of the radius may involve articular surface frequently. Intraoperative assessment of fixation with the help of an image intensifier has always been difficult because of the anatomy of the distal radius. Use a periosteal elevator to lift the pq muscle from the radius.
Wrist spanning plates offer a temporary internal fixation. 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. In cases where a procedure has been done to the dorsal aspect of the lunate, such as kienbocks disease cases, this. The titanium volar plates are available in a wide array of sizes narrow, standard, and wide and in multiple shaft lengths. The evolution of distal radius fracture management a. Bartons fracture an intraarticular fracture of the distal radius with dislocation of the radiocarpal joint. Soong and colleagues 7 recently described a grading system for classifying volar plate prominence following distal radius fracture fixation. The knowledge of these fractures has grown enormously over the last years. Korean type distal radius anatomical volar plate system. Consult medartiss entire wrist catalogue on medicalexpo. Comprehensive plating system providing anatomical volar and dorsal, universal volar and fragment. The influence of distal screw length on the primary.
Similar to volar plating, one of the proximal andor distal screw holes may need to be cut from the plate to prevent plate impingement. We aimed to evaluate the results of volar locking and unlocking plate fixation of adult distal radius fractures. Pdf volar plate fixation of distal radius fractures. Distal radius fracture is the most common fracture of the upper extremity, with an annual incidence of 2 to 4 per 1,000 persons. Fully revised and expanded, with new illustrations and radiographs and new chapters on the dis.
Click on your rehabilitation protocol to download a pdf file containing specific exercises and instructions for. Minimally invasive hardware removal after minimally invasive distal. Repositioning and stabilization of the radial styloid process. This elevated posture likely represents a significant risk factor that has played a role in drfs being the most common fracture treated by physicians. Hearon wrist hand protocols this subsection of our website contains rehabilitation programs or protocols designed for patients recovering from wrist or hand surgery.
An anatomical study of the watershed line on the volar, distal aspect of the radius. To open a pdf file you will need compatible software such as adobe reader. It is composed of a multitude of closely balanced structures, e. Download acrobat pdf file 377kb recommended articles citing articles 0. It acts as the link between radius and ulna and a pivot for pronosupination. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Anatomy and biomechanics of the distal radioulnar joint. Pdf most of the documents on the racgp website are in portable document format pdf. A comprehensive offering of volar plates are available in narrow, standard, and wide as well as multiple shaft lengths. Arthrex arthrex distal radius plate surgical technique. Korean type distal radius anatomical volar plate system clinics in orthopedic surgery vol. Open reduction and internal fixation of comminuted, displaced intraarticular or potentially unstable fractures of the distal radius with plate and screws has increasingly become a favoured treatment.
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. Specific qualitative and quantitative features of the distal radius fracture apparent on the radiograph are discussed. Risk factors for complications after locked volar plate fixation to identify risk factors for complications after volar. The typical deformity of the distal radius malunion has three components. Assessment of a novel biomechanical fracture model for distal. Reliability of the soong classification for volar plate. Internal distraction plating of highly comminuted distal radius fractures. Variations of plate shapes include h frame, straight. The hand is one of the most complex and most frequently utilized parts of the human musculoskeletal system. Locking plates for fixation of extraarticular fractures of the first metacarpal base. While immobilization has served as the only available treatment for most of our history, many advances. Management distal radius and distal ulnar fractures with.
The ulna is the stable unit of the forearm around which the radius rotates the anatomy of the sigmoid notch of the radius, the seat of the ulna and the guiding checkrein potential of the components of the tfc allow. Distal radius fractures are frequently seen in elderly patients and are injuries that can cause a loss of wrist function. Example of hardware removal after distal radius fracture. Finally, the influence of distal screw length was only assessed for the most common distal radius fracture ao23 a3 using a biomechanical fracture model.
Additional dorsal support of the articular surface and the dorsal edge fragment via the second row of screws. Distal radius fractures drf are one of the most common fractures and often need surgical treatment, which has been validated through biomechanical tests. Implications for plate placement and avoidance of tendon ruptures. Whether this concept can be adapted to fractures in vivo and intraarticular distal radius fractures ao23 c has yet to be evaluated. We conclude with a series of questions the radiologist should address in the initial description of fracture involving the distal radius. Pdf to evaluate the efficacy of plates and screws with angular stability in. Anatomical fit of seven different palmar distal radius plates. Fixation of the radial fracture is completed using a plate and screws. Wrist medartis pdf catalogs technical documentation. Giant cell tumor of distal radius after open reduction inter. The fracture of the distal radius is the most common fracture we treat.
Read pdf dvr crosslock distal radius plating system surgical techniquearthrex distal radius plate surgical technique steven j. The radii were cut to a length of 140 mm and equipped with variable angle, volar locking plates adaptive distal radius plate 2. Repositioning and stabilization of the radial styloid. Dorsal displacement with loss of radial inclination the osteotomy is best performed at the site of the deformity. The origin of the flexor pollicis longus fpl muscle may be partially released for added exposure. Apr 22, 2016 distal radius plate and lcp the locking plate has changed the way to treat distal radial fractures 40.
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. Comprehensive plating system providing anatomical volar and dorsal, universal volar and fragment specific solutions. Anatomic reduction and fixation of unstable distal radius. A distal ulna excision had previously been performed for ulnocarpal impaction.
The influence of distal screw length on the primary stability. Distal radius fractures are the most common fractures of the upper extremities. Extensor tendon irritation is one of the most common complications following volar locking plate osteosynthesis vlpo for distal radius fractures. The dorsal approach to treatment of distal radius fractures had fallen into disfavor over the past several years because of reports of tendon irritation, rupture, and potential fracture collapse that may occur with the relatively high profile first generation dorsal plates. 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. Newclip technics, haute goulaine, france, and in 1 case an aptus plate medartis, basel, switzerland. The titanium wrist plating system is designed for fixation of intraarticular and extraarticular fractures, osteotomies, and nonunions and malunions of the distal radius.
Although sometimes stated otherwise, the outcome of these fractures is not uniformly good regardless the treatment instituted. The aim of the study was to develop a new standardized fracture model for drf ao23. Assessment of a novel biomechanical fracture model for. Stainless steel versus titanium volar multiaxial locking. This article is from bmc musculoskeletal disorders, volume 15. Twelve adult wrists from fresh cadavers six males, six. The purpose of this study was to compare the anatomical fit of different, precontoured palmar distal radius plates. Plate and screw design in fractures of the hand and wrist. The distal radius plate instrument and implant set tg pdf. The pronator quadratus muscle is dissected away and the fracture is reduced. An anatomical study of the watershed line on the volar. Prospective evaluation of distal radius fractures treated. Giant cell tumors gcts of the distal radius are lowgrade malignant lesions that are locally aggressive and can metastasize to the lung and bone. The arthrex titanium volar distal radius plating system provides a comprehensive solution for distal radius fracture management.