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Bridge Plating for Distal Radius Fractures and Fracture Dislocations of the Wrist

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

This video demonstrates bridge plating of the wrist. The primary indications for bridge plating of the wrist include radiocarpal dislocations, severely comminuted and osteoporotic fractures of the distal radius, and very distal radius fractures or distal radius fractures that are difficult to manage via nonspanning implants. The technique is performed according to the following steps. The skin over the distal portion of the third metacarpal, distal radius, and radial shaft proximally is incised. The radial shaft and metacarpal are exposed. The extensor pollicis longus tendon and the distal radius are dissected. The proximal and distal tracts are developed. The dorsal plate is passed. The screw holes are drilled. Two distal screws and one proximal screw are inserted. Evaluation for overdistraction is performed, and radiographs are assessed. Two patients are presented in the video, demonstrating the usefulness of bridge plating.

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