Wrist Fractures: Fixation With Ulnar Styloid Plating Animation

Wrist Fractures: Fixation With Ulnar Styloid Plating Animation

This animated video will provide a surgical demonstration for treating a wrist fracture utilizing an ulnar styloid plate. 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 tip of the ulna is fractured, also called an ulnar styloid fracture, and the joint is unstable between the ulna and radius, a plate will be needed to stabilize the injury. Here is a left hand with a fracture to the end of the ulna. A temporary wire is first placed in the end of the bone to stabilize the fractures. Once stabilized, a plate with a hook at the end, often called a hook plate, will be introduced through an incision on the side of the wrist. The hook will be used to stabilize the ulnar styloid.

A drill guide and drill will be used to make a hole in the bone for the first screw. The hole will be measured, and the proper-sized screw will be placed. Then a different type of drill guide is used for a type of screw called a locking screw. These screws have threads that engage with the threads in the plate, which provides more stability, preventing movement. Once the hole is drilled, the locking screw will be placed.

Additional locking screws will be placed in the same manner in additional holes depending on the injury and surgeon preference. The temporary wire will then be removed. A final screw can be placed to provide additional compression between the hooks of the plate if needed. Once the plate is in place and the fractures are stabilized, the alignment will be confirmed on x-ray. The incisions will then be closed, and the surgery is complete.