SURGICAL TECHNIQUE

 

1
Preparation

Make a longitudinal incision slightly radial to the flexor carpi radialis tendon (FCR) (Figure 1). Dissect between the FCR and the radial artery, exposing the pronator quadratus (Figure 2). Detach the pronator quadratus from the lateral border of the radius and elevate it toward the ulna (Figure 3).

 

2
Reduce fracture and position plate

Reduce the fracture using the preferred reduction technique.
The reduction method will be fracture specific.
Apply the plate to fit the extra-articular volar surface and insert a 2.4 mm or 2.7 mm cortex screw in the elongated hole in the plate shaft.
Measure screw length using the depth gauge. Adjust the plate position as necessary and tighten the screw with a T8 StarDrive Screwdriver.

 

3
Insert proximal screws

Determine where 2.4 mm variable angle locking screws or 2.4 mm or 2.7 mm cortex screws will be used in the shaft of the plate. Insert these screws beginning with the most proximal screw.

 

4
Drill for variable angle screw distally

The 2.4 mm variable angle locking screws may be inserted in the head of the plate. Use the cone-shaped end of the universal variable angle locking drill guide to drill variable angle holes at the desired angle. Alternatively, use the 1.8 mm variable angle drill guide, cone. The drill guide tip keys into the cloverleaf design of the VA LCP Plate holes.

 

5
Preliminary screw placement

Insert the correct length variable angle locking screw or variable angle locking buttress pin manually, using the self-retaining T8 StarDrive Screwdriver shaft and handle with quick coupling. Insert the screw until the screwhead is seated in the variable angle locking hole. Do not overtighten the screw. Insert additional screws as needed.

 

6
Confirm proper joint reconstruction

Confirm proper joint reconstruction, screw placement and screw length using multiple C-arm views. To ensure that the distal screws are not in the joint, use additional views such as a 10° dorsally tilted, 20° inclined lateral, and 45° pronated oblique view.

 

7
Lock variable angle screws

Use the 0.8 Nm torque limiting attachment (TLA) for final tightening of the 2.4 mm VA locking screws or 1.8 mm VA locking buttress pins.

 

8
Close incision

Use the appropriate method for surgical closure of the incision.