Biomechanical analysis of volar and dorsal double locking. Other optimised features include a lower profile, polished finish which may help minimize soft tissue irritation, and converging ulna screws. 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. Choose the appropriate implant according to patient anatomy and fracture pattern. Distal radius fractures are among the most common fractures seen in the hospital emergency department. Distal radius fracture is the most common fracture of the upper extremity, with an annual incidence of 2 to 4 per 1,000 persons. Distal radius plates inlay for universal volar distal radius plates ref description implant module 2912 29 29114 2924 variax lid for sterilizing container sterilizing container, halfsize, wo variax lid variax distal radius plating instrument tray variax distal radius bone reduction tray ref description sterilizing container. Kadakia is a codesigner of the acumed ankle plating system 3, which features seven plate families to treat the distal fibula and tibia.
Acumed total wrist fusion lating system surgical technique neutral plate standard plate 3 plate placement standard plates small plates the total wrist fusion plate, standard 700325 or 700326 or total wrist fusion plate, small 700327 or 700328 is placed on the dorsum of the index metacarpal and carpus and dorsoradially on the distal radius. The fibula locking plate is a proven osteosynthesis system for various distal fibula fractures. Fractures of distal radius account for up to 20% of all fractures treated in emergency department. For fragmentspecific fracture fixation with variable angle locking technology. Internal fixation plates for distal radius fractures.
Internal fixation for the distal radius by david l. Arthroscopically asisted orif with volar plate fixation for distal radiu. Instruments and implants approved by the ao foundation. The distal ulna locking plate is a plate system which can be implanted with locking screws adjusted to the contour of the distal ulna. It can also be used in conjunction with the acumed forearm rod system for a less invasive approach to bothbone fractures of the. Acumed has introduced the aculoc 2 volar distal radius vdr plating system as the next generation in plating fixation. Volar plate fixation of intraarticular distal radius.
In recent years, great changes have taken place both in the treatment options of the distal radius and the patient demands which have increased. Volar distal radius locking plate that best accommodates patient anatomy and fracture pattern. The aculoc 2 volar distal radius plating system comprises a locking plate and percutaneous fragloc compression screws for the fixation of dorsal fragments. A metal plate shaped to fit the contours of the radius is inserted and positioned against the bone. A comprehensive offering of volar plates are available in narrow, standard, and wide as well as multiple shaft lengths. Metaanalysis for dorsally displaced distal radius fracture. Early palmar plate fixation of distal radius fractures may. Volar plate fixation of distal radius fractures jorge orbay, md miami hand center, 8905 southwest 87 avenue, suite 100, miami, fl 33176, usa reliable internal.
Proximal row of the head of the plate remove each f. Percutaneous kirschner wire kwire fixation and orif with palmar plating are the most used fixation methods of displaced drfs. The physician creates an incision along the palm side of the forearm to access the end of the radius. Using the same driver, fill the holes in the head of the plate with the appropriate length locking screws or pegs. Distal suture holes for additional soft tissue fixation chamfered distal plate edge for minimal implant protrusion low plate profile of 1. Anatomic features of the distal radius include the styloid process, the dorsal tubercle, and four surfaces. Evidence based postoperative treatment of distal radius. The acumed anatomic midshaft forearm plating system offers marked hardware improvements over traditional straight plates. Lee, md, new york, ny presents the arthrex volar distal radius plate technique. Geminus volar distal radius plate skeletal dynamics.
The acumed aculoc 2 proximal volar distal radius vdr plates are designed for distal radius fracture and osteotomies, as well as segmented diaphyseal fractures. The plate can be adjusted proximal or distal through the use of the oblong hole. Variable angle lcp twocolumn volar distal radius plate 2. Distal radius fracture repair with volar plate central. Percutaneous k wire vs volar plate j bone joint surg am. Product labeled in part, aculoc distal radius plate, standard, left. Acumed offered an innovative solution for repairing intraarticular fractures, malunions, and nonunions of the. The screw trajectory is designed to allow screws to capture platkng fragments and avoid other screws regardless of the screw length selected. Dvr crosslock distal radius plate distal plate fixation cont.
Acumed aculoc2 volar distal radius surgical technique curmed ag. Comments about the acumed aculoc 2 volar distal radius. However, there is no current consensual evidence to guide the selection of one technique over the other. Case 2 comminuted, dorsallydisplaced fracture of the distal radius. Compliance report a complaint advamed code of ethics. Introduction 1 pointed hooks and locking screw in the head pointed hooks to grip the styloid process and to act as reference point for plate application. Plate position the plate is designed to sit along the distal aspect of the radius to support the volar articular fracture fragments and just proximal to the watershed line to minimize tendon irritation. Korean type distal radius anatomical volar plate system clinics in orthopedic surgery vol. Aculoc 2 volar distal radius plating system surgical.
Limited contact a limited contact undersurface is designed to ease compression of the periosteum to minimize distla decrease in blood supply to the. In this live surgery, lamont cardon, md treats a 54yearold patient with an aculoc 2 volar distal radius vdr proximal plate to repair an extraarticular distal radius fracture. Distal radius plate in titanium orthopaedic implants. 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. Study finds plating distal radius fractures effective but costly. Jul 15, 2015 dorsally displaced distal radius fractures dddrf are frequent injuries in clinical practice.
Dorsal plate fixation for distal radius fractures springerlink. In recent years with the advent of low profile plating. For fixation of complex intra and extraarticular fractures and osteotomies of the distal radius and other small bones. Acumed s distal clavicle plates are designed to be placed more distal than most other clavicle plates. Screw trajectories are designed to provide optimal subchondrial support. Symptoms include pain, bruising, and rapidonset swelling. It occurs in middle aged and elderly women commonly. It consists of the carpus, distal ulna and distal radius. Volar distal radius plate preoperative templates cat. In addition, converging ulnar screws, suture holes, and kwire holes have been incorporated. Acumed aculoc 2 volar distal radius plating system. Alians distal radius range right plates green anodized dtdvpn2 20. Failure of a volar locked plating is a rarely reported complication in the literature.
Orif fracture of the distal radius with volar acumed plate. The acumed elbow plating system offers multiple fixation platibg for fractures of the distal humerus, olecranon, and coronoid. As palmar plating of distal radius fractures drfs became more popular, the incidence of operative treatment increased, particularly among older women chung et al. Plates, dorsal distal radius plates, distal radius fragment specific plates, and volar distal ulna plates. The original aculoc volar distal radius plate has been a market leader in fracture fixation since its introduction in 2004. 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. Orif fracture of the distal radius with volar acumed plate dan hutt. The insertion of the brachioradialis may be released. Modality of treatment for the distal end radius fracture. Evidence about the acumed aculoc 2 volar distal radius. Two contoured radius plate options acumed offers two plate types for the radius, including volar and dorsolateral approach options. Intercrossing locking screws securely hold the ulnar head. Emerging technologies in distal radius fracture fixation. Orthopedics today in the world of hand surgery, new surgical techniques and implants promising to provide reliable solutions for treating distal radius fractures come and go.
The acumed system was the first elbow plating system to offer precontoured, parallel distal humerus plates. Nov 25, 2010 volar locking plates provide significant structural stability to the distal radius. 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 testing was performed on 28 cadaveric specimens and demonstrated that a volar locking distal radius plate dvr plate, hand innovations exhibited higher bending stiffness 16. The titanium volar plates are available in a wide array of sizes narrow, standard, and wide and in multiple shaft lengths. Fractures of the distal radius are the most common fractures in the human body. Along with the proximal and distal radioulnar articulations, an interosseous membrane originates medially along the length of the body of the radius to attach the radius to the ulna. Guide insert with the square driver after checking the drilled depth figure 18. Volar locking plate fixation of distal radius fractures. Cm henn, sw wolfe distal radius fractures in athletes.
Campbellopen reduction and internal fixation of intraarticular and unstable fractures of the distal radius using the ao distal radius plate j hand surg br, 25 2000, pp. A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Distal radius fractures, in the forearm closer to the hand, are the most common fractures in the body. Screws are used to anchor the plate to the bone, stabilizing the radius. Variax distal radius locking implant module, doublesized inlay for anatomical volar distal radius plates inlay for universal volar distal radius plates ref description implant module 2912 29 29114 2924 variax lid for sterilizing container sterilizing container, halfsize, wo variax lid variax distal radius plating instrument tray. Furthermore, in the usa, the annual incidence of distal forearm fractures attributable to osteoporosis is 250,000 per year 7.
In many cases, they can be treated with a cast or brace, but the more severe ones that are. The lcp diameta diaphysealmetaphyseal volar distal radius plate is an anatomic plate designed for fractures of the distal radius that extend into the radial shaft. Note the periloc volar distal radius plate preoperative templates 71180981, 71180982 are available to assist with preoperative radiographic planning. The dorsal lunate plate is designed to provide support to fracture patterns that involve the dorsal lunate facet of the distal radius. 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. Distal radius fractures are no exception to this increase and constitute up to 15% of all extremity fractures. Parallel plating the firsttomarket precontoured elbow plates are designed to provide multiple fixation options for fractures of the distal. The distal end of the radius forms two palpable points, radially the styloid process and listers tubercle on the ulnar side. Also poor contact between the plate and the anterior cortex of the distal radius is a factor leading to plate failure. The dorsal lunate plate is designed to provide support to fracture patterns that involve the dorsal lunate facet of the distal radius and the sigmoid notch. Surgical technique this publication is not intended for distribution in the usa. The acumed hand plating system is intended for the managemnent of fractures, fusions, and osteotomies of the distal, mdl.
Novel dual head minimizes plate profile, reducing the potential for flexor tendon injuries. Customizable plate length and width options allow for sizing of varying patient anatomies. Dorsal plate fixation is an important and useful treatment strategy for certain types of distal radius fractures. Korean type distal radius anatomical volar plate system. Distal radius anatomy applied to the treatment of wrist. General features of distal radius anatomy the distal portion of the radius has a quadrilateral crosssection and includes the metaphyseal and epiphyseal regions. Volum 22, number 1, march 2014, pages 2938, 02012014. Standard plates include the offset plate, 6 and 10hole straight plates, and t plates. Currently, in the study of distal radius fractures, the biomechanical and clinical correlations between the reduction of the bony structures radial height, ulnar inclination, palmar inclination. Arthrex arthrex distal radius plate surgical technique. Dorsal and volar plates for fractures and osteotomies of the distal radius. The system includes extension plates where fixation of long segments is required, and complementary distal radius fragment specific plates. To further assist with complications of wrist fractures, osteotomies, and other wrist injuries, acumed has introduced three additional plate families to the system.
The titanium wrist plating system technique is designed for fixation of intraarticular and extraarticular fractures, osteotomies, as well as nonunions and malunions of the distal radius. Plate selection following fracture reduction, select the volar distal radius locking plate that best accommodates patient anatomy and fracture pattern. The arthrex distal radius dorsal plate allows direct buttressing of dorsal comminution while keeping a low profile repair to reduce extensor tendon irritation. The system can be used to treat fractures, fusions, and osteotomies of the radius and ulna. Results measurements showed a mean dorsal hook angle of product overview the acumed elbow plating system offers multiple fixation options for fractures of the distal humerus, olecranon, and coronoid, as well as osteotomies of the olecranon. Acumed ankle plating system 3 cadaver lab part 3 proximal. Winstar distal radius plate 4hole, left and right material. Of these, over 40% are considered unstable and require some form of fixation. Variax distal radius locking plate system stryker meded. Failure of volar locking plate fixation of an extraarticular. Then from 2005 onwards, for the remaining 50 patients with 52 fractures, the plates used were the dvr. All fractures were treated by using a fixedangle locking plate dvr, biomet, miami, florida, usa and a single volar incision overlying the fcr tendon. Fractures of the distal ulna usually occur in association with distal radius fractures. The system presents several plate options, a unique twopiece locking compression screw, innovative instrumentation for fracture management, and plate placement tools.
The plate should be placed slightly below the distal edge of the radius to support the volar articular fracture. Pdf stainless steel versus titanium volar multiaxial. Take special care to confirm the presenceabsence of an ulnar volar fragment on imaging. Biomechanical evaluation of volar locking plates for distal. As distal radius fractures have become one of the most common injuries treated with internal fixation, oic supports surgeon and facility in achieving great outcomes under increasing reimbursement pressures.
Dtdvps2 polyaxial plate for distal radius standard head size 2 right dtgvps2 polyaxial plate for distal radius standard head size 2 left dtdvps3 polyaxial plate for distal radius standard head size 3 right dtgvps3 polyaxial plate for distal radius standard head size 3 left. External fixation vs volar plate j bone joint surg am. Titanium winstar distal radius plate 3hole, left and right material. Extraarticular volar distal radius plates plate positioned away from articular surface diverging screws secure styloid and distal fragments for fixation of simpler fractures 2 synthes 2. A 40 yearold, obese female patient who presented with a displaced extraarticular distal radius fracture, underwent open reduction and internal fixation of the fracture using a volar locking plate. It also occurs in young men with high velocity, injury. Bend the kwire out of the way to facilitate drilling.
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