Anatomic Fit of Six Different Radial Head Plates: Comparison of Precontoured Low-Profile Radial Head Plates

Is an extension of the safe zone possible without jeopardizing the proximal radioulnar joint when performing a radial head plate osteosynthesis?

“…Our results extend the conclusions of Giannicola et al 5 and Burkhart et al 3 For 2 of the 5 plates we studied, the radial neck plates (MBP and SNP), the anterior edge of the plate could partially pass the lesser sigmoid notch of the ulna and significantly increase the size of the SZ in maximum pronation. Conversely, placement of each of the 3 radial head plates must fully respect the SZ.…”

“…On the basis of the study of Burkhart et al, 3 Both the MRP and MBP are available in a single size. The plates are made of grade IV titanium, are 1.3 mm thick, and have 2.0-mm screw options (multidirectional locking and nonlocking).…”

Anatomical Variations of the Proximal Radius and Their Effects on Osteosynthesis

“…These investigations showed that none of the tested plates exhibited good congruence to the safe zone in most cases analyzed, nor was a significant improvement found in the plate-bone congruence after plate bending. 12,13 In keeping with this, our results suggest that if the different morphological types of the proximal radius are not taken into account by the plate design, an osteosynthesis of the radial head may fail to reconstitute the original morphology, especially when the severity of injury causes a loss of anatomical landmarks. We found that in the presence of a type A radius, the positioning of a pre- 17,20 -22 we believe that preoperative templating of the contralateral radius may be useful before operating on comminuted Mason type II and III fractures.…”

“…12 In addition, a study investigating the anatomical fit of 6 different plates in 22 cadaveric radii showed that none of the tested devices exhibited an adequate fit in most cases. 13 These findings suggest that substantial morphologic variations of the proximal radius exist among subjects and that such anatomical variations should be considered when restoring the proper anatomy of the proximal radius.…”

Salter-Harris II forearm fracture reduction and fixation using a buttress plate

“…There is, however, some evidence that plate fixation may lead to better outcomes than wire fixation 8 16. Despite this, plate fixation can still have complications (eg, soft tissue irritation and/or need for plate removal17). Wires cross the physis and can therefore lead to further trauma and possible growth disruption; however, plate fixation with distal and proximal screws could disrupt growth on the side the plate is placed.…”