Total Wrist Fusion Plating System Surgical Technique
Hand & Wrist – Total Wrist Fusion Plating System
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Total Wrist Fusion Plating System
Overview
The Total Wrist Fusion Plating System was designed for wrist arthrodesis due to deformities associated with degenerative arthritis, brachial plexus palsies, and spastic disorders. This five plate system features both innovative and traditional designs.
Specifically, four of the five plates are positioned on the second metacarpal. These left and right specific designs are positioned on the second metacarpal which may reduce extensor tendon irritation.
Additionally, the fifth plate is a neutral option that is placed on the third metacarpal and developed for use with a proximal row carpectomy.
All plates have a 15 degree dorsal bend, established as a balance between anatomic resting position, hand function, and grip strength.
Hexalobe MultiScrews with SaveLock Compression Sleeve
The SaveLock Compression Sleeve allows the Hexalobe MultiScrew to function as both a locking and nonlocking screw all in one. When inserted in to the unthreaded slots of the Total Wrist Fusion Plate the Hexalobe MultiScrew is nonlocking, allowing the plate to compress to the bone.
When inserted into threaded holes, the Hexalobe MultiScrew acts as a locking screw, creating a strong screw-plate interface. Reducing the plate to the bone, the SaveLock Compression Sleeve prevents the Hexalobe MultiScrew from locking into the plate until the SaveLock Compression Sleeve is disengaged.
Indications for Use
- Post-traumatic arthritis of the joints of the wrist
- Rheumatoid wrist deformities requiring restoration
- Complex carpal instability
- Post-septic arthritis of the wrist
- Severe unremitting wrist pain related to motion
- Brachial plus nerve palsies
- Tumor resection
- Spastic deformities
Key Features
Approach-Specific Plate Options
The system offers left and right specific plates as well as a neutral plate. All plates have a 15-degree bend that is intended to maximize grip strength.1
Second Metacarpal
The system includes four plates designed specifically for second metacarpal placement to avoid flexor tendons.
Ulnar Deviation
Second metacarpal plate placement puts the wrist into ulnar deviation. This is intended to allow better grip strength.1
Converging Screw Design
The plates’ converging distal screw design is intended to assist with pullout resistance.
Neutral Plate Option
The Neutral Plate was designed to be used with a proximal row carpectomy.
1. Field J, Herbert TJ, Prosser R. Total wrist fusion: a functional assessment. J Hand Surg Am. 1996;21B(4):429–433.
Total Wrist Fusion Using the Second Metacarpal Plate with Robert Bass, MD
The Acumed Total Wrist Fusion Plating System was designed for wrist arthrodesis due to deformities associated with degenerative arthritis, brachial plexus palsies, and spastic disorders.
In this video, Dr. Bass demonstrates his surgical technique for wrist arthrodesis using the Acumed Total Wrist Fusion Plate, standard, on the second metacarpal.
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