2.4 mm VA-LCP Dorsal Distal Radius Plate
Dorsally displaced fragments which cannot be securely fixed through a volar approach need stabilization (often by simple buttressing) on the dorsal surface. The convex shape of the dorsal aspect of the radius causes the distal screws of fixed angle devices to point towards the center of the radius, so they cannot be directed parallel to the distal radioulnar joint for optimal support. Using a fixed angular locking dorsoulnar plate which has to be placed very distally can lead to screws entering the joint. This problem can be solved by tilting the screw in the variable angle locking-plate hole proximally. Variable angle technology allows up to 15 off-axis screw angulation which can provide better support of the distal radioulnar joint and/or more secure fixation of the radial styloid.
The 2.4 mm VA-LCP dorsal distal radius plate adds variable angle technology to the existing double plate concept of the 2.4 mm LCP dorsal distal radius plates. Additionally, new anatomically preshaped plates have been added to the set: one for the radial column in two different lengths, and one for the intermediate column, also in two different lengths and in left and right versions. All plates are highly polished and have rounded edges to minimize the risk of soft-tissue irritation and tendon ruptures.
The recommended operating room technique for a dorsal shearing fracture is to apply the dorsoulnar plate first, fixed only by a cortex screw in the oblong combination hole. After, the dorsoradial plate is applied in the same way. The locking screws are then inserted in the dorsoulnar plate, starting with the most proximal hole. Finally, locking screws are placed in the dorsoradial plate in the same order. The VA instrumentation allows repositioning of nonoptimally placed screws.
Laboratory cyclical-load testing to determine plate strength to failure confirmed that VA plates are as strong as (or stronger than) Pi-Plate with the anatomical prebend plates being stronger than the flat ones.
Besides the anatomically preshaped radial and intermediate column plates, there is a total of 14 different flat plates available including T-, L-, and oblique L-plates in different lengths. All plates are available in stainless steel and titanium (TiCp).
Case 1: A 62-year-old man fell on his outstretched left hand while playing tennis, sustaining an intraarticular fracture of the distal radius, Mller AO Classification 23-C3.2.
Case provided by Renato Fricker, Bruderholz, Switzerland
Case 2: A 44-year-old man sustained polytrauma following a car accident. Among his injuries was a distal radial fracture, Mller AO Classification 23-C1.
Case provided by Vitezslav Ruber, Brno, Czech Republic
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