WRIST SYSTEM DORSAL RADIUS PLATE Surgical Technique

Surgical Technique Plate Variation 2 ARIX Wrist System Dorsal Radius Plate

Objective Restoration of the intra- and extra-articular anatomy of the distal radius. Stable internal fixation of fragments, with the possibility of early functional rehabilitation. Indication The ARIX Wrist System(Radius) is intended for use in forearm fractures, osteotomies and arthrodesis. Contraindications General medical contraindications for surgical intervention. Distal radius fractures with palmar tilt of the distal fragment.

Advantages • Anatomic reconstruction of the radiocarpal joint under direct vision. • Restoration of length and axes. • No need for cancellous bone grafting if fixed-angle plates are used. • Early functional rehabilitation of the wrist. • The plates are not prominent due to their reduced thickness. Radial column plate Intermediate column plate Left 4-6 Locking hole 25-DDRA-0XX Series 4 ARIX Wrist System Dorsal Radius Plate 6-8 Locking hole 25-DDRA-2XX Series

Surgical Technique 1. Approach Straight skin incision from the basis of metacarpal II, ending approximately 5 cm proximal. 2. Reduce fracture Reduce the fracture under radiographic imaging. If necessary, fix the articular fragments, following anatomic reduction, with Kirschner wires or reduction forceps. 3. Place intermediate column plate Place the intermediate column plate over the reduced fracture(111-068-2). If necessary, fix it provisionally with 1.1 mm guide pin. If necessary, bend the plate to suit to the bone shape. Required Instruments Guide Pin 111-068-2

Surgical Technique 4. Drill screw hole Using drill guide(111-080), drill through the oblong hole. 5. Measure required screw length Using depth gauge(111-075), determine screw length. 6. Insert cortical screw Insert cortical screw with STARIX T8 screwdriver(113-HF-613). Adjust the plate position and tighten the screw. Required Instruments Drill Guide 111-080 6 ARIX Wrist System Dorsal Radius Plate

Surgical Technique 7. Place Radial column plate Place the radial column plate and insert Ø 2.5 mm cortical screw in the oblong hole in the proximal shaft. The angle between two plates should be approximately 70°. Follow the step 4 to step 6 to insert cortical screw. Use the small notch in the distal end of the plate to position the radial column plate properly.

Surgical Technique 8. Insert variable angle locking screws Locking screw insertion order 1 Insert screws in intermediate column plate Insert a Ø 2.5 mm locking screw in most proximal hole in the shaft of the intermediate plate 1 . Insert Ø 2.5 mm locking screws in the distal holes of the plate 2 , 3 . 1 2 Insert screws in radial column plate Insert a Ø 2.5 mm locking screw in the most proximal hole of the radial column plate 4 . Complete internal fixation by inserting Ø 2.5 mm locking screws in the distal end of the plate 5 , 6 . 8 ARIX Wrist System Dorsal Radius Plat

Surgical Technique How to insert locking screws 1 Mount the variable angle drill guide(111-080) in the variable angle locking hole. Alternatively the variable angle drill sleeve(111-103) can be applied. Use the drill bit(112-25-701) to drill to the desired depth, at the desired angle. 2 Determine screw length using the depth gauge(111-075). 3 Insert screws with STARIX T8 screwdriver(113-HF-613). Required Instruments Drill Guide 111-080 Screwdriver Handle Optional 111-092 Drill Sleeve Handle 111-157

Surgical Technique How to use variable angle drill sleeve 1 The Variable Angle Drill Sleeve enables the screw to be inserted at a user preferred angle within ±15° range. 2 The Drill Sleeve Handle allows for ease of insertion of the drill guide and ensures better visibility for targeting. Before positioning the Drill Sleeve, engage it with the Sleeve Handle. After the Drill Guide is fully engaged with the plate, disconnect the Drill Sleeve Handle. The Drill Sleeve Handle is not required when removing the Drill Sleeve. Required Instruments Required Instruments Drill Sleeve 111-103 10 ARIX Wrist...

Surgical Technique 9. Confirm proper joint reconstruction and close incision Confirm proper joint reconstruction, screw placement and screw length using multiple radiographic images. Use the appropriate method for surgical closure of the incision 70°- 90° 10. Implant removal To remove locking screws, first unlock all screws from the plate, then remove the screws completely from the bone. The last screw removed should be a cortical screw on the shaft. Required Instruments

Plate Variation Distal Dorsal Radius Plates Radial column plate Intermediate column plate Light blue Light blue Light blue Light blue Light blue Light blue Light green Light green Light green 12 ARIX Wrist System Dorsal Radius Plate

Distal Dorsal Radius Plates 1 25-DDRA-004 Radial Column Plate, Length 51.0 mm 2 25-DDRA-005 Radial Column Plate, Length 57.5 mm 3 25-DDRA-006 Radial Column Plate, Length 64.0 mm 4 25-DDRA-106 Intermediate Column Plate, Right, Length 45.0 mm 5 25-DDRA-107 Intermediate Column Plate, Right, Length 51.0 mm 6 25-DDRA-108 Intermediate Column Plate, Right, Length 57.0 mm 7 25-DDRA-206 Intermediate Column Plate, Left, Length 45.0 mm 8 25-DDRA-207 Intermediate Column Plate, Left, Length 51.0 mm 9 25-DDRA-208 Intermediate Column Plate, Left, Length 57.0 mm Optiona Optiona Optiona Optiona Optiona Optional...

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