Locking Plate Technology

By using locking screws in a bone plate, a fixed-angle construct is created. In osteopenic bone or fractures with multiple fragments, secure bone purchase with conventional screws may be compromised. Locking screws do not rely on bone/plate compression to resist patient load, but function similarly to multiple small angled blade plates. In these cases, the ability to lock screws into a fixed-angle construct is imperative. By combining locking screw holes with compression screw holes in the shaft, the plate can be used as both a locking device and a fracture compression device. If compression is desired, it must be achieved first by inserting the standard screws in the compression screw holes before inserting any locking screws. The locking plate design does not require compression between the plate and bone to accommodate loading. Therefore, screw thread purchase in the bone can be achieved with a thread depth less than that of traditional screws. The shallow thread profile, in turn, allows for screws with a larger core diameter to accommodate loading with improved bending and shear strength.

Locking Screw Technology

The heads of the locking screws contain male threads while the holes in the plates contain female threads. This allows the screw head to be threaded into the plate hole, locking the screw into the plate. This technical innovation provides the ability to create a fixedangle construct while using familiar plating techniques.

Plate Features

Features of the Periarticular Locking Plate include:

• Plates are precontoured to help with metaphyseal/diaphyseal reduction

• Thick-to-thin plate profiles make the plates autocontourable

• Anatomical contouring of the plates matches the shape of the distal radius

• Low plate profile facilitates fixation without impinging on soft tissue

• Plates are available in left and right configurations, in a variety of lengths

Indications

The Periarticular Locking Plate System is indicated for temporary internal fixation and stabilization of osteotomies and fractures, including:

• Comminuted fractures

• Supracondylar fractures

• Intra-articular and extra-articular condylar fractures

• Fractures in osteopenic bone

• Nonunions

• Malunions

specifications

Distal Dorsal Radial Delta Locking Plate: A Comprehensive Guide

When it comes to treating distal radius fractures, one option that surgeons may consider is the use of a distal dorsal radial delta locking plate. This type of plate has gained popularity in recent years due to its ability to provide stable fixation, allowing for early mobilization and a quicker return to daily activities. In this article, we will provide a comprehensive guide to the distal dorsal radial delta locking plate, including its indications, surgical technique, and potential complications.

Introduction

Distal radius fractures are a common injury, particularly in older adults. While many fractures can be treated conservatively with immobilization, some may require surgical intervention. The use of a distal dorsal radial delta locking plate is one surgical option for these fractures. This plate is designed to provide stable fixation while allowing for early mobilization and return to function.

Anatomy of the Distal Radius

Before discussing the use of a distal dorsal radial delta locking plate, it is important to understand the anatomy of the distal radius. The distal radius is the part of the forearm bone that connects to the wrist joint. It is a complex structure with multiple articular surfaces and ligaments. Injuries to this area can vary in severity, from a small crack to a complete fracture.

Indications for Distal Dorsal Radial Delta Locking Plate

The use of a distal dorsal radial delta locking plate may be indicated for certain types of distal radius fractures. These may include:

• Intra-articular fractures

• Comminuted fractures

• Fractures with significant displacement

• Fractures with unstable ligamentous injuries

Preoperative Planning

Preoperative planning is essential when considering the use of a distal dorsal radial delta locking plate. This may include obtaining appropriate imaging studies, such as X-rays or a CT scan, to fully evaluate the fracture. Additionally, the surgeon will need to determine the appropriate plate size and shape, as well as the optimal placement of screws.

Surgical Technique

The surgical technique for using a distal dorsal radial delta locking plate typically involves the following steps:

1. An incision is made over the distal radius to allow access to the fracture site.

2. The fracture is reduced, or realigned, as necessary.

3. The plate is positioned on the dorsal side of the radius.

4. Screws are inserted through the plate and into the bone to secure it in place.

5. If necessary, additional fixation, such as wires or pins, may be used to further stabilize the fracture.

Postoperative Care

After surgery, patients may require immobilization for a short period of time before starting physical therapy. The goal of therapy is to restore range of motion and strength while protecting the healing bone. Patients may be able to return to daily activities as early as six weeks after surgery, although the timeline may vary depending on the severity of the fracture.

Potential Complications

As with any surgical procedure, there are potential complications associated with the use of a distal dorsal radial delta locking plate. These may include:

• Infection

• Implant failure

• Nerve or blood vessel injury

• Stiffness or loss of range of motion

• Delayed union or nonunion of the fracture

Alternative Treatment Options

While a distal dorsal radial delta locking plate may be an effective treatment option for certain types of distal radius fractures, there are alternative treatments that may be considered as well. These may include:

• Closed reduction and casting: For less severe fractures, immobilization with a cast may be sufficient to promote healing.

• External fixation: This involves using pins or wires that are inserted through the skin and into the bone to stabilize the fracture.

• Volar locking plate: This is an alternative plate that is placed on the palmar side of the radius.

The choice of treatment will depend on the specific fracture and the individual patient's needs and preferences.

Patient Education

For patients considering the use of a distal dorsal radial delta locking plate, it is important to fully understand the benefits and risks of the procedure. Patients should be informed about the expected recovery timeline, potential complications, and any restrictions on activity that may be necessary during the healing process. Additionally, patients should be encouraged to ask any questions they may have and to actively participate in their care.

Future Directions and Innovations

As with any medical technology, the use of distal dorsal radial delta locking plates is constantly evolving. There are ongoing efforts to improve the design and materials used in these plates, as well as to develop new techniques for placing them. Additionally, researchers are exploring the use of other technologies, such as 3D printing and biologics, to further enhance the treatment of distal radius fractures.

Conclusion

The use of a distal dorsal radial delta locking plate can be an effective option for certain types of distal radius fractures. However, it is important to carefully evaluate each patient's individual needs and consider alternative treatments as well. With proper preoperative planning, surgical technique, and postoperative care, patients can expect to achieve good outcomes and return to their daily activities.