Wrist Fractures: Management With Spanning Wrist Plating Animation

Wrist Fractures: Management With Spanning Wrist Plating Animation

This animated video will provide a surgical demonstration for treating a wrist fracture utilizing a spanning wrist 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 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 wrist will be placed into alignment by manually pulling on the hand. The plate will be placed through incisions on the top of the radius and a hand bone called a metacarpal.

To prepare for an incoming screw, a drill guide and drill will be used to make a hole in the bone that aligns with a hole in the plate. The depth of the hole will be measured with a depth gauge so the proper-sized screw is used. The screw is then placed. The same process is then repeated to secure the plate to the radius bone. The 2 holes used here are oblong, which allow for fine-tune adjustments in the alignment and position of the plate.

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.

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.