Wrist Fractures: Fixation With a Wrist Hook Plate Animation

Wrist Fractures: Fixation With a Wrist Hook Plate Animation

This animated video will provide a surgical demonstration for treating a wrist fracture utilizing a hook plate. The wrist joint comprises 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.

When the thin edge of the palm side of the radius is injured, it is essential to ensure the fragment of bone is stabilized well to prevent later complications in the joint. An implant called a hook plate can be used in this circumstance. Here is a left hand with a fracture on the edge of the palm side of the radius. A temporary wire will be placed in the broken fragment to hold the bone in alignment.

A template, mirroring the actual plate, will be used for drilling, and is slid over the wire and placed in position through an incision at the base of the wrist. A drill guide has already been screwed into the template. Another temporary wire is placed in the bottom of the plate and bone to further maintain alignment. Two additional drill guides are already in the template. A drill will be introduced through the guide to place holes for incoming prongs on the hook plate.

The recently placed temporary wire is removed, and another hole is drilled. The plate guide is then removed, and the hook plate is introduced, aligning the 2 tines, or prongs, with the holes drilled at the base of the radius. Light pressure will be used to engage the prongs with the holes. Once the plate is flush, a screw will be inserted in the oblong hole in the plate to compress the fracture site. The remaining holes will be filled with screws. The initial temporary wire will be removed. The incision will be closed, and the surgery is now complete.