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Hook Plate Fragment Specific Fixation for Volar and Dorsal Rim Distal Radius Fractures
Alex Kelsheimer, DO1,2, Meera Gill, DO1 and Jason A Nydick, DO3, (1)Florida Orthopaedic Institute, Temple Terrace, FL, (2)Orthopedic Specialists, St. Louis, MO, (3)Florida Orthopaedic Institute, Tampa, FL

Hypothesis: The use of fragment specific fixation, specifically volar and dorsal hook plates, for distal radius fractures will result in stable fracture fixation and predictable fracture healing. Additionally, fragment specific fixation will have a low complication profile with a low rate of secondary surgeries for hardware removal.
Methods: A retrospective chart review was conducted on 20 patients treated with a volar and/or dorsal hook plate in the management of comminuted, intra-articular distal radius fractures with a volar and/or dorsal marginal rim fragment. Clinical and radiographic outcomes were assessed.
Results: This series included 20 patients, 11 females and 9 males, with an average age of 50 and follow up of 7 months (range, 2-23 months). All patients had maintenance of reduction at their final follow-up. No patients had failure of hardware or hardware-related complications. Fourteen patients required adjunct plating. Seven of those patients required dorsal spanning plates which were all removed. Two patients required removal of their hook plate hardware due to pain; one volar hook plate and one dorsal hook plate were removed.
Summary Points:

  • All fractures healed and maintained reduction at their final follow-up.
  • Hook plate fixation allows for stable alignment and reduction of volar and dorsal rim fractures.
  • Hook plate fixation can be used safely with additional plates (dorsal spanning, radial styloid pin plate, dorsal column pin plate, and dorsal ulnar pin plate) to maintain overall fracture alignment and reduction
  • There were no hardware failures or hardware related complications.
  • Low hardware complication profile with only two patients requiring hardware removal.



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