Wrist Fractures: Management With Spanning Wrist Plating
Wrist Fractures: Management With Spanning Wrist Plating
This surgical video demonstrates a spanning wrist plate for the treatment of a wrist fracture.
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Wrist Fractures: Management With Spanning Wrist Plating
This video will demonstrate the surgical repair of a distal radius fracture using a wrist spanning plate on a cadaveric specimen. The wrist joint is comprised of the ends of 2 bones in the forearm, called the radius and ulna, and a row of small bones called carpal bones. Wrist fractures most commonly impact the end of the radius and are referred to as distal radius fractures. Often, the end of the ulna bone will also be fractured when the radius is injured.
In cases where the fractures are complex and involve many unstable pieces, a spanning plate may be used to hold alignment during healing. Often, these are removed when the bone is healed. Here is a left hand. The surgeon will begin by making an incision overlying a bone in the hand called a metacarpal, mindful of nearby structures such as small nerves. An instrument called a freer will elevate soft tissue off the bone. The surgeon will use the freer to make a path to the top of the radius bone.
A surgical incision will then be made on top of the radius. The freer tip is shown in the incision over the radius, passing through the recently created tunnel. The surgeon will then pass the plate through the tunnel between the 2 incisions. Through the oblong screw hole, the surgeon will place an initial screw into the bone. Another screw will be placed at the radius end of the plate, and an x-ray will be taken to confirm the placement of the screw. There is no fracture seen on this x-ray given the cadaver's normal anatomy.
Additional screws have now been placed in the metacarpal bone and the other end of the plate in the radius bone. X-rays are taken to confirm the placement of each screw. A final incision is then made over the end of the radius in the middle of the plate in preparation for a final screw. The screw is placed for additional support. Final x-rays will be taken to confirm placement of the plate and screws. The incisions will be closed, and the surgery is now complete.