Purpose
This study aimed to measure the angles between the screw and plate in 16 commercially
available volar locking plates (VLPs) to determine the fixable intra-articular fragment
size.
Methods
Ulnar orientation angles (axial plane) and elevation angles (sagittal plane) between
the distal ulnar screw and plate were measured for 14 fixed-angle VLPs and 2 variable-angle
VLPs. Each VLP was simulated by 2 surgeons to sit distally and ulnarly in 10 normal
distal radius models. The distance between the screw and distal/ulnar end of the distal
radius on both the volar and dorsal sides, designated as the longitudinal/lateral
distance, was measured to identify the fixable size of the 2 intra-articular fragments:
volar lunate fragment and dorsoulnar fragment. Relationships between the ulnar orientation
angle and dorsal-side lateral length as well as the elevation angle and dorsal-side
longitudinal distance were analyzed.
Results
The ulnar orientation and elevation angles ranged from 6.5° to 16.9° and −5.8° to
34.3°, respectively, for fixed-angle VLPs and −12.5° to 32.2° and 3.1° to 42.1°, respectively,
for variable-angle VLPs. The minimal longitudinal distances on the volar side with
the fixed- and variable-angle VLPs were 4.3–10.9 mm and 5.8–5.9 mm, respectively.
On the dorsal side, the lateral distance negatively correlated with the ulnar orientation
angle (R = −0.74), and the longitudinal distance negatively correlated with the elevation
angle (R = −0.89).
Conclusions
The Depuy Synthes variable-angle VLP provides an advantage for fixating small intra-articular
fragments. For fixed-angle VLPs, the Mizuho VLP provides an advantage for fixating
small volar lunate fragments. A narrow dorsoulnar fragment can be fixated using a
plate with a large ulnar orientation angle, such as the Zimmer Biomet or Mizuho VLP.
Clinical relevance
The ability of each individual commercially available plate to capture specific intra-articular
fragments should be known.
Key words
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Article info
Publication history
Published online: June 19, 2021
Accepted:
May 12,
2021
Received:
June 11,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
