scholarly journals Volar Locking Plate Breakage after Nonunion of a Distal Radius Osteotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Sergi Barrera-Ochoa ◽  
Sergi Rodríguez-Alabau ◽  
Andrea Sallent ◽  
Francisco Soldado ◽  
Xavier Mir
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Demineralized Bone Matrix ◽  
Plate Fixation ◽  
Corrective Osteotomy ◽  
Bone Matrix ◽  
Early Mobilization ◽  
Osteotomy Site ◽  
Volar Locking Plate ◽  
Plate Breakage

We report a 38-year-old male with a nonunion followed by plate breakage after volar plating of a distal radius osteotomy. Volar locking plates have added a new approach to the treatment of distal radius malunions, due to a lower morbidity of the surgical approach and the strength of the final construction, allowing early mobilization and return to function. Conclusion. Plate breakage is an uncommon complication of volar locking plate fixation. To our knowledge, few cases have been described after a distal radius fracture and no case has been described after a distal radius corrective osteotomy. In the present case, plate breakage appears to have occurred as a result of a combination of multiple factors as the large corrective lengthening osteotomy, the use of demineralized bone matrix instead of bone graft, and the inappropriate fixation technique as an unfilled screw on the osteotomy site, rather than the choice of plate.

Surgical Technique of Corrective Osteotomy for Malunited Distal Radius Fracture Using the Computer-Simulated Patient Matched Instrument

2016 ◽  
Vol 21 (02) ◽  
pp. 133-139 ◽  
Author(s):  
Tsuyoshi Murase
Keyword(s):  
Bone Graft ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Corrective Osteotomy ◽  
Extensor Tendon ◽  
Radius Fracture ◽  
Soft Tissue Release ◽  
Dorsal Plate ◽  
Volar Locking Plate

The conventional corrective osteotomy for malunited distal radius fracture that employs dorsal approach and insertion of a trapezoidal bone graft does not always lead to precise correction or result in a satisfactory surgical outcome. Corrective osteotomy using a volar locking plate has recently become an alternative technique. In addition, the use of patient-matched instrument (PMI) via computed tomography simulation has been developed and is expected to simplify surgical procedures and improve surgical precision. The use of PMI makes it possible to accurately position screw holes prior to the osteotomy and simultaneously perform the correction and place the volar locking plate once the osteotomy is completed. The bone graft does not necessarily require a precise block form, and the problem of the extensor tendon contacting the dorsal plate is avoided. Although PMI placement and soft tissue release technique require some degree of specialized skill, they comprise a very useful surgical procedure. On the other hand, because patients with osteoporosis are at risk of peri-implant fracture, tandem ulnar shortening surgery should be considered to avoid excessive lengthening of the radius.

scholarly journals Clinical and Functional Outcome of Volar Locking Plate Fixation for Distal Radius Fracture

2009 ◽  
Vol 58 (2) ◽  
pp. 283-286 ◽  
Author(s):  
Shoichi Kuba ◽  
Itaru Furuichi ◽  
Masakazu Murata ◽  
Takeshi Miyaji ◽  
Noriaki Miyata ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Radius Fracture ◽  
Volar Locking Plate ◽  
Locking Plate Fixation

Detecting dorsal screw penetration following volar plate fixation of the distal radius – A validation study in a saw bone model

Trauma ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 46-53 ◽  
Author(s):  
William EC Poole ◽  
Daniel Marsland ◽  
Piyush Durani ◽  
Chris M Hobbs ◽  
Philip S Sauvé
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Lateral View ◽  
Volar Locking Plate ◽  
Perfect Agreement ◽  
Bone Model ◽  
Observer Reliability ◽  
Screw Penetration ◽  
Screw Threads

Background The fluoroscopic detection of dorsal screw protrusion following volar locking plate fixation of distal radius fractures remains difficult. The carpal shoot through view has recently been reported to result in a 17% intra-operative screw exchange rate. The aim of the current study was to assess the sensitivity of the carpal shoot through view in comparison to conventional fluoroscopic views for detecting dorsal cortical and distal radio-ulnar joint screw penetration. Methods A volar locking plate was applied to a saw bone model and fluoroscopic views taken with the distal screws inserted flush or protruding by two full screw threads. Images were then shown to 10 orthopaedic surgeons who were asked to identify excessively long screws. Results The CST view demonstrated the greatest sensitivity for detection of dorsal screw penetration (78%). Its inter-observer reliability was 0.66 (substantial agreement) and intra-observer reliability 0.86 (near perfect agreement). The dorsal skyline had a sensitivity of 51%; the elevated lateral view had a sensitivity of only 16%. Conclusions The current study confirms that the elevated lateral view cannot be relied upon alone for the detection of dorsal screw penetration. The CST view is a valid technique demonstrating the greatest sensitivity in comparison to established intra-operative views.

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