Variable Angle LCP Distal Radius System 2.4
Fig 1 
Fig 2 The variable angle LCP distal radius system 2.4 is indicated for fixation of complex intra- and extraarticular fractures and osteotomies of the distal radius and other small bones (Fig 1). The new variable angle technology enhances fragment-specific fracture fixation by providing the flexibility to lock screws in trajectories that diverge up to 15 from the central axis of the plate hole (Fig 2). The plates are precontoured to match the anatomy of the volar distal radius. Variable angle locking holes in the head of the plate enable placement of the screws at the most appropriate position to create a locking construct to support the articular surface and reduce the need for bone graft.
The system consists of the variable angle LCP two-column volar distal radius 2.4 and the variable angle LCP volar extraarticular distal radius 2.4. Both plate types use 2.4/2.7 mm cortex or 2.4 mm locking screws in the plate shaft, and 2.4 mm variable angle locking screws in the head of the plate. The variable angle locking screws are available in sizes from 8 mm to 30 mm. All plates are available in stainless steel or CP4 titanium.
A special drill guide allows up to a 15 angulation around the central axis of the locking hole (Fig 3).
Fig 3a 
Fig 3b Case 1: 22-year-old male fell off a horse while playing polo.
Case provided by Ladislav Nagy, Zrich, CH
Fig 1a-b Preoperative x-rays.
Fig 2af Preoperative 3-D CT scans.
Fig 3ac Immediate postoperative x-rays.
Fig 4ab X-rays 3 months postoperatively.
Case 2: 36-year-old female fell down on a meadow.
Case provided by Ladislav Nagy, Zrich, CH
Fig 1ab Preoperative x-rays.
Fig 2ab X-rays postoperatively.
Fig 3ab X-rays 5 months postoperatively.
Cases 3 and 4 provided by Max Daniel Kauther and Marcel Dudda, Essen, Germany
Case 3: Multifragmentary distal radius fracture with extension into the diaphysis
A 26-year-old man suffered a multifragmentary fracture of his left distal radius with extension into the diaphysis (AO23 C3.3) (Fig 1). The VA LCP Extra Long Two-Column plate was used for fixation (Fig 2). After initial immobilization, the plate provided a good postoperative fixation of the fracture.
The fracture showed primary bone healing without callus formation. At the 3-month follow-up, the patient was full weight bearing with excellent clinical function (Fig 3). The radiological follow-up can be technically challenging due to the correct focus of the central ray.
Fig 1 Preoperative images. 
Fig 2 Images at the 3-month postoperative follow-up. 
Fig 3 Good clinical function at the 3-month postoperative follow-up. Case 4: Open radius shaft fracture
A 59-year-old farmer suffered a crush injury with an open forearm fracture (AO22 C2, Gustilo and Anderson IIIB) (Fig 1). Initial stabilization was carried out by external fixator (Fig 2). After four rounds of debridement and capillary ingrowth of a splitting skin graft at day 17, the VA LCP Extra Long Two-Column plate was used for fixation of the radius. A 2.7 mm LCP Condylar Plate was used for fixation of the ulna. The plates provided good stability for a functional after-treatment.
At the 3-month follow-up, the patient was full weight bearing with healing fractures (Fig 3).
Fig 1 Preoperative images. 
Fig 2 Initial fixation by external fixator. 
Fig 3 The images at the 3-month follow-up. Hazards and labeling
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