2.4 mm VA -LCP Two-Column Volar Distal Radius (Narrow), for Small Stature

Douglas Campbell
The 2.4 mm variable angle LCP two-column volar distal radius system has been expanded by the addition of a small stature version specifically designed for the narrow radii of small-statured patients. The existing smallest available plate in the system may be too wide for this group of patients.

Changes to the plate include; merging of central holes in the plate head, reduction in plate head angle from 25° to 20°, more rounded edges on both the radial and ulnar sides and increased divergent pre-defined screw angles. The narrow plate also comes in a left and right version with four different shaft lengths (42 to 72 mm and 2 to 5 holes) and two corresponding guide blocks. The plates are available in stainless steel and titanium as well as sterile and non-sterile. A trial implant allows determination of correct plate size in regions with sterile implants only. This trial implant may be fixed temporarily through K-wire holes.
The 2.4mm variable angle LCP distal radius two column plate system is indicated for fixation of complex intra- and extra articular fractures and osteotomies of the distal radius. The 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. The plates are pre-contoured 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 which will support the articular surface and reduce the need for bone graft.

The system consists of the 2.4 mm variable angle LCP two-column volar distal radius and the 2.4 mm variable angle LCP volar extra articular distal radius plates. 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 from 830 mm.

The design of the 2.4 mm variable angle LCP two-column volar distal radius plate reflects the need to reconstruct and stabilize the load-bearing radial and, more importantly, intermediate columns of the distal radius, as well as the sigmoid notch (which forms part of the distal radioulnar joint). As such, it provides stability to the areas of the radiusshown to be biomechanically crucial in force transmission, as well  as to the distal part of the forearm rotation mechanism.

A young woman, 1,5 m tall, 45 kg, sustained a very distal C1.1 fracture of the distal radius.

Fig 1 Intraoperative view showing reposition of the radiocarpal joint with the K-wire.

Fig 2 Stabilization of the radiocarpal articular surface with one single 2.4 mm screw at the level of the watershed line, and narrow plate below the watershed line.

Fig 3ac Postoperative x-rays showing comparison of plate alternatives.  

Case provided by Martin Langer, Mnster, Germany

Age 63, male, motorcycle accident

Case provided by Dr. Apikit, Thailand

Fig 1a-b Preoperative x-rays

Fig 2a-b Post-op immediate

Fig 3a-b Post-op 3 months

Fig 4a-d Functional Result: 12 weeks post-op

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