Zimmer Distal Radius Plating System ® Surgical Technique

Zimmer® Distal Radius Plating System Surgical Technique Introduction The Zimmer® Distal Radius Plating System is a versatile system carefully designed to meet the needs of both patients and surgeons. Using Zimmer’s anatomical database, the plate contour conforms to a broad range of patient anatomy and the screw trajectories target the most common fragment and fracture patterns, all while limiting the construct interference with soft tissues. Zimmer has designed the Distal Radius Plating System for ease of use and polyaxial screw placement. The system offers comprehensive instrumentation to ensure...

Zimmer® Distal Radius Plating System Surgical Technique Zimmer Distal Radius Plating System Plate Families Dorsal and Radial Styloid Plates Wide Volar Plates Standard Volar Plates Features Plate Contour The contour was optimized using Zimmer’s proprietary ZiBRA™ Anatomical Modeling System to ensure appropriate fit for a broad patient population. Minimal Screw Head Prominence These low-profile, periarticular plates are anatomically contoured to reduce soft-tissue irritation by minimizing screw head prominence even when the screws are used off-axis. Locking Mechanism Polyaxial screw locking is...

Zimmer® Distal Radius Plating System Surgical Technique Screw Features Screw Options • 2.4mm Locking Screws Ease of Use All screws have been streamlined to use one drill bit and one depth gauge, simplifying the instrumentation for ease of use. The drill bit is etched to measure for screw length, saving time and reducing the number of steps to complete the procedure. Flexibility The locking screws and pegs in this system can be angled up to 15 degrees off-center or follow a fixed-angled trajectory with a standard locking drill guide or a drill guide block. Variable Angle Trajectory Color Coded...

Zimmer® Distal Radius Plating System Surgical Technique Instrumentation Simplified The set includes specialized instrumentation geared to make the use of the system easier. Comprehensive Offering Cobra Hohmanns Wider Cobra Hohmann retractors allow improved fracture site exposure and visualization. Weitlaner Retractors Retractors specific for distal radius cases; deep teeth with a wide spread to improve exposure. Polyaxial Drill Guide Simple design to target hole and place drill bit within cone of polyaxiality. Olive Wires Shorter Olive Wires to stay out of the way of the drill while temporarily...

Zimmer® Distal Radius Plating System Surgical Technique Surgical Approach Volar Approach Patient Positioning Position the patient supine and place the forearm on a radiolucent hand table. (Fig. 1) Patient Positioning 1. Incision Make a longitudinal incision slightly radial to the flexor carpi radialis tendon (FCR). (Fig. 2) 2. Superficial Dissection Retract the FCR tendon toward the ulna while protecting the median nerve. Dissect through the floor of the FCR sheath, protecting the radial artery radially, exposing the pronator quadratus (PQ). (Fig. 3) 3. Deep Dissection Release the PQ radially...

Zimmer® Distal Radius Plating System Surgical Technique Fracture Reduction and Temporary Fixation 1.25mm K-wires can be used to obtain and maintain accurate fracture reduction when applying the distal radius plate. Before Plating: • Reduce fracture. • Insert K-wires to hold the reduction. (Fig. 5) • If needed, K-wires can be inserted parallel to the subchondral bone to reconstruct the articular surface. (Fig. 5) • Ensure that K-wires are placed in locations which will not impede proper plate placement and fixation. Note: K-wires and drill bits are single use only. Fig. 5 Hold reduction with K-wires...

Zimmer® Distal Radius Plating System Surgical Technique Step 2: Plate Position The plate should be positioned on the distal radius proximal to the Watershed line. If placed properly, 1.25mm K-wires inserted into the two distal K-wire holes will not violate the joint. (Fig. 8) Note: The two distal K-wire holes match the trajectory of their adjacent screw holes. The K-wire holes are offset slightly more distal to ensure that the nominal trajectory of the screws will not be in the joint if the K-wires show proper placement under flouroscopy. Fig. 8 Check distal K-wire placement Note: If bending...

Zimmer® Distal Radius Plating System Surgical Technique Step 4: Check Distal K-wire Placement Check 1.25mm K-wire to verify that the screw trajectory will not violate the joint. (Fig. 10) Step 5: Optional Distal Cortical Screw Placement Insert 2.4mm Cortical Screws into the distal holes using the instructions in Step 3 as needed to lag the plate and bone together and/or to assist in fracture reduction. (Fig. 11) Fig. 10 Lateral view check of Distal K-wire placement Fig. 11 Optional Distal Cortical Screw placement Calibrated Drill Bit, AO, 1.8mm Diameter 00-2366-030-18 Smooth Drill Guide for use...

Zimmer® Distal Radius Plating System Surgical Technique Step 6: Insert 2.4mm Locking Screws Distally Option 1: Fixed angled screw insertion without Drill Guide Block (Fig. 12a) • Thread the 1.8mm Locking Drill Guide into selected hole. • Drill with 1.8mm Drill Bit. • Measure depth. Select appropriate screw. • Insert screw using T8 Driver Shaft and AO Type Collet Handle assembly. Fig. 12a Fixed angle screw placement without Drill Guide Block Option 2: Polyaxial locking screw insertion (Fig. 12b) • Thread Polyaxial Drill Guide into selected hole. • Drill with 1.8mm Drill Bit. • Measure depth. Select...

Zimmer® Distal Radius Plating System Surgical Technique Step 7: Insert Remaining Proximal Screws Repeat procedure from Step 3 or Step 6 to insert 2.4mm Cortical Screws or 2.4mm Locking Screws in desired proximal holes. (Fig. 13) Step 8: Final Check and Closure Check screw position using flouroscopy and ensure final tightening before closure. Note: To ensure screws are not in the joint, the forearm can be elevated 10 degrees in the Anterior to Posterior view and 20 degrees in the Lateral to Medial view. Fig. 13 Positioning of Volar Plate Construct Calibrated Drill Bit, AO, 1.8mm Diameter 00-2366-030-18...