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February 19, 2016
Contributors: Nicholas A Kusnezov, MD; John Dunn, MD; Michael Ting, BS; Miguel A Pirela-Cruz, MD; Miguel A Pirela-Cruz, MD
Keywords: Bony Procedure
In this video, the authors demonstrate bridge plating of the wrist. The primary indications include radiocarpal dislocations, severely comminuted and osteoporotic fractures of the distal radius, and very distal or distal radius fractures that are difficult to address with non-spanning implants. The technique is performed using the following steps:
1) incision of the skin over the distal portion of the third metacarpal, distal radius, and radial shaft proximally;
2) exposure of the radial shaft and metacarpal; 3) dissection of the extensor pollicis longus tendon and distal radius;
3) development of the proximal and distal tracts;
4) passage of the dorsal plate;
5) drilling of the screw holes;
6) insertion of two distal screws and one proximal screw;
7) checking for over-distraction; and
8) x-ray evaluation. Two cases were presented demonstrating the usefulness of bridge plating.