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As medical practitioners, we must do what’s best for the patient with all the skills, experience, and technology at our disposal. Where most modern internal fixation systems will not cause any discomfort for years, it is never guaranteed. Therefore, situations may arise that warrant the removal of orthopaedic plates from the body. In order to recommend this course of action, it is necessary to make patients aware of the potential consequences. This includes the reasoning, process, and recovery time. The latter of which we shall be focusing on here.

When is plate removal necessary?

The removal of an orthopaedic plate for internal fixation is often only required when the plate itself is causing significant issues in the patient. This can be due to pain, discomfort, infection, allergic reaction, non-union, or other complication arising due to the individual’s biology. In these cases, the plate has served its function of stabilising the affected area bone. However, it still remains in the body.

Although the surgical procedure needed to remove the plate causes little discomfort to the patient, it is often highly skill-intensive for the surgeon. A small incision is made in the skin above the fixation site, which allows access to the hardware. Once the screws and plates have been removed from the body, any soft tissue can be repositioned and the incision can be closed. Some of the potential risks associated with plate removal surgery include:

• Refracture.
• Possibility for only partial removal.
• Nerve damage.
• Bleeding and blood clots.

Patient recovery times following orthopaedic plate removal

When considering patient recovery time from surgeries involving bone structures, practitioners must focus on bone strength. In cases of orthopaedic plate removal, it has been shown that it often takes around 6 months for patient bone strength to recover fully. In the weeks immediately following the procedure, patients will likely feel week and only notice recovery to start properly after 2-3 months. This may vary depending on what the plate was used to treat when it was initially implanted. For instance, fragment plating for a distal radius fracture or wrist plating for fractures caused by a direct impact. Here, patient recovery times can be shortened by plating systems that fit flush to patient anatomy as they reduce risks in the removal process.

Factors that can impact patient recovery times

As is the case with any invasive procedure, there can a range of patient-specific factors that can lead to longer recovery times. This includes:

• Age.
• Genetics.
• Long term conditions.
• Past surgeries and injuries.

Patient advice following surgery

Patients may understandably have a number of questions regarding what they should and shouldn’t do in the weeks following the plate removal procedure. This can cover a range of areas, such as:

• Washing – keep dressings clean and dry at all times. Bathing the wound may be permitted 2-3 weeks after the surgery, with a follow-up consultation typically taking place during this time.
• Changing dressings – using clean hands, remove the tensor bandage if one is present and then throw away the used white gauze bandages. Cover the wound with new dressing, taking care to make sure the pressure is moderate.
• Wound care – it’s normal for some fluid to ooze from the area in the first 24-48 hours after surgery. This can be cause to replace the dressing, which can be bought from most pharmacies. In between replacing the dressing, it is recommended that the area is cleaned lightly.
• Activities – recommendations will depend on the location where the surgery has been performed. For instance, lower extremity plate removal will typically need greater care. In either case, physical therapy is not usually needed.

Patients should be advised to call a healthcare professional if they experience persistent pain, swelling, fever, nausea, bleeding, or shortness of breath post-operation.

Source industry leading orthopaedic implants

The team at LEDA Orthopaedics specialise in distributing leading products for use in osteotomy surgeries and internal fixation procedures. You can regularly find us attending medical events across the UK to help share surgical knowledge and advance the field. This includes techniques and devices for the extremities, as well as niche applications. Contact us for more information about our suppliers.

A joint fusion is exactly what it sounds like – it’s a procedure that holds the two ends of bone in place at the joint and allows them to fuse together. The result is that the bones in the joint are permanently held in the same position. Joint fusions are frequently performed at small joints for a number of reasons, which we’ll be discussing in this article.

Small joint fusion procedures

Joint fusion surgery typically begins with a small incision at the back side of the joint. This is typically guided with X-rays, although L3D Osteotomy Planning can be used to great effect here as well. This technology creates 3D models of patient anatomical structures, which allows surgeons to plan procedures with absolute precision. This can be crucial in reducing risk of damage to surrounding soft tissues during orthopaedic surgeries.

Ligaments are carefully moved to either side of the joint in preparation for open reduction and internal fixation. An expert surgeon can then remove damaged pieces of bone and cartilage at the joint, allowing the bone ends to be brough together. Connective hardware is applied to hold the bones in position and allow them to fuse together. Fixation can be achieved through a combination of orthopaedic devices, such as arthrodesis screws and plates. Bone grafts may be needed to replace sections of bone before fusion, although this will depend on the condition of the bones at the joint.

Why perform small joint fusions?

One of the most common reasons to recommend a joint fusion is in patients suffering from complications due to osteoarthritis. Here, small joint fusions in particular see regular use as the condition tends to affect smaller joints that are used more often (hand and wrist). For instance, those experiencing carpometacarpal joint pain. Alongside arthritis symptoms, any disease that causes a degradation in bone stock can be a cause for joint fusions.

Oftentimes, small joint fusions are recommended once other procedures have proven ineffective for the patient. Fortunately, there are orthopaedic implants which have been specifically designed for finger joint replacements. These are the DIGITALIS MCP and DIGITALIS PIP respectively, both supplied by BRM Extremities.

Patient recovery from joint fusion

In most cases, it takes 4-6 weeks for a patient to make a full recovery from a small joint fusion. During this time, it is recommended that they apply a splint and/or strapping to the affected area to limit movement. However, recovery time may be extended by various factors relating to the patient or the kinds of activities they wish to return to. For instance, if the patient’s job involves lifting heavy objects it could best to recommend 6-8 weeks before they return to work. This helps to avoid the main complication which can arise from the procedure – bones failing to fuse. In these cases, additional surgery might be required to achieve permanent fusion. Although through the application proper fixation devices and orthopaedic expertise, this should not be necessary.

Leaders in orthopaedic solutions

At LEDA orthopaedics, we are proud to be at the forefront of patient care through providing solutions to ongoing bone conditions. We partner with distributors of orthopaedic devices, systems, and instrumentation from around the world to bring innovation and quality to the operating theatre. Contact us directly through our website to discuss how we can help advance the industry.

As medical practitioners, providing good patient experiences is just as important as securing positive outcomes. In this regard, prescribing post-operative support is among the most effective options at our disposal. It could be recommendations for physical exercises to strengthen joints, or systems that limit movement to prevent re-injury. For the latter, elbow splints see regular use in patients that are recovering from upper extremity surgery. Below are some of the common reasons why orthopaedic surgeons may find it necessary to fit a patient with an elbow splint.

Function of an elbow splint

Elbow splinting can come as either static or dynamic, depending on the range of motion it allows at the joint. A static elbow splint holds the elbow in place and does not allow for any movement. In contrast, a dynamic elbow splint allows basic bending and straightening (hinge) of the elbow. Although it can also be locked in a specific position to fully limit movement. The goal of elbow splinting is to promote healing at the elbow joint following elbow trauma and/or elbow surgery. This is accomplished by keeping the joint warm, helping increase blood flow, and controlling movement, which can prevent further injuries.

Reasons for fitting an elbow splint

There are several reasons why a patient might need to wear an elbow splint:

• Fractures: Following a fracture or break in one of the bones of the elbow (such as the radius, ulna, or humerus), a splint may be used to immobilize the elbow joint and allow the bones to heal properly.
• Strains or sprains: Injuries to the ligaments or tendons around the elbow joint, such as a sprained ligament or strained muscle, may require immobilization to reduce pain and promote healing over time.
• Tennis Elbow (Lateral Epicondylitis): This condition involves inflammation of the tendons on the outside of the elbow. A splint can help to reduce strain on these tendons and provide support during activities that aggravate the condition. This condition can also occur in patients that regularly play a range of sports, with another common example being Golf.
• Olecranon Bursitis: This is inflammation of the bursa, a fluid-filled sac that cushions the bones of the elbow. A splint can help to reduce pressure on the bursa and alleviate pain.
• Post-Surgery: After certain surgeries on the elbow, such as ligament repairs, joint replacement, or osteotomies, a splint may be used to immobilize the joint and protect the surgical site during the initial stages of healing.
• Preventative Measures: In some cases, especially for individuals who engage in repetitive activities that put strain on the elbow joint, a splint may be used as a preventative measure to reduce the risk of injury or to provide support during rehabilitation.

It’s important that healthcare professionals assess the specific condition and needs of the patient to determine whether a splint is appropriate and, if so, what type of splint would be most beneficial. Each case will likely also lead to an elbow splint being recommended for differing periods of time. Additionally, advice should be given on proper fitting and usage instructions to ensure the effectiveness of the splint.

eXo Eblow Splint

The Jake Design eXo Elbow Splint has been designed expressly to aid patients in postoperative recovery. This dynamic splint is simple to adjust, lightweight, comfortable, and washable. The eXo splint can also be used to treat those suffering from joint afflictions such as arthritis and carpal tunnel syndrome.

Access devices for quality patient care

At LEDA Orthopaedics, we are aware of the complications that can come with operating on patients with a sporting history or that are older. So while we partner with a range of suppliers for surgical implants to treat injuries such as elbow fractures, we also distribute equipment for postoperative care. Contact us for more information.

The thumb plays an essential role in hand function and when it is injured or damaged, its absence can significantly impact a person’s ability to live their normal life and complete everyday tasks. Thumb replacement can offer patients lifechanging improvements to their hand function and symptoms they were experiencing in relation to their thumb. In this article we’ll be explaining what a thumb replacement is and how it is beneficial for patients.

What is thumb replacement surgery?

Thumb replacement or thumb joint replacement is a procedure that is commonly carried out in cases where the patient is suffering with severe arthritis or osteoarthritis. This type of surgery involves removing the arthritic joint at the base of the thumb and then replacing it with an artificial joint.

Early implants for thumb replacements were made of silicone, but as technology has progressed implants have evolved and improved. They are now made using metal such as nickel or titanium or pyrocarbon with cushioning synthetic spacers that sit between the bones.

When is thumb replacement needed?

This procedure is typically performed to ease symptoms of severe pain at the bottom of the thumb and offer better mobility in the joint. Patients are often encouraged to try other forms of treatment before surgery such as painkillers, splints, steroid injections, and activity modifications to ease their symptoms. However, in serious cases where quality of life is being affected, individuals can seek thumb replacement surgery.

Metal joint replacements are a favourable choice for older patients with arthritic symptoms and the operation is minimally intrusive. Therefore, they will probably experience faster healing and rehabilitation periods. Certain implants can be inserted without the need to remove the trapezium (a bone located at the thumb’s base), thereby preserving healthy tissue. This could enhance strength and offer alternatives for future procedures if necessary. For a CMC joint replacement to be considered, the adjacent joint must be free of arthritis and in good health, and the trapezium should be sufficiently large to accommodate the replacement.

What are the benefits of a thumb replacement?

There are several reasons why a thumb replacement would be considered as a lifechanging procedure. The main benefits of the procedure are:

Restored functionality

The thumb is essential for various types of hand function such as grasping, pinching, and manipulating objects. A successful thumb replacement can restore some of these key movements, allowing the individual to regain more independence in their daily activities.

Better dexterity

The opposable thumb is a unique human feature that enables us to be able to carry out intricate tasks. Thumb joint replacement aims to restore as much opposable function in the thumb as possible. As a result, patients will be able to better perform tasks that need precision and dexterity including writing and typing.

Improved quality of life

Pain in the thumb caused by arthritis damage or an injury can have a substantial effect on a person’s quality of life. A thumb replacement can be transformative in terms of pain relief and improving quality of life for those who have felt limited by their symptoms.

MAIA CMCJ replacement

The MAIA CMCJ replacement created by Groupe Lepine is designed for the surgical treatment of basal thumb osteoarthritis. It has many impressive features that make it a useful prosthesis for surgeons completing thumb replacement procedures. These features include:

• Dual mobility that ensures stability and reduces the risk of dislocation.
• Hemispherical trapezium cup available in 8mm, 9mm, and 10mm options with 4 pins for core stability.
• Modern, cannulated instrumentation for accurate implantation.
• Implants have a dual coating of porous titanium and hydroxyapatite for uncemented fixation.
• Titanium necks available for nickel-sensitive patients.

For more information about the MAIA CMCJ replacement contact our specialist team of orthopaedic distributors at LEDA Orthopaedics. We love hearing patient success stories from the surgical solutions we supply. See the impact a CMCJ arthroplasty can have with the MAIA replacement in our recent LinkedIn post (link to be embedded).

A fracture to the top of the upper arm bone (humerus) can have severe consequences for patients, especially those who are physically active for work or leisure. There can be a number of factors that can contribute to a fracture of the humerus. Being aware of what causes these injuries helps medical professionals deliver better lasting quality of care and improve patient experience. You can find this information further down in the post.

What is a proximal humerus fracture?

Proximal humerus fractures involve the top end of the upper arm bone. This bone runs from the should down to the elbow joint. As a result, it is crucial for many regular arm movements such as opening doors. A proximal humerus fracture can occur in many different forms, with the most common being either a simple or comminuted fracture. Although these fractures can also be classified by the shape or angle of the break, including:

• Transverse fracture.
• Buckle fracture.
• Oblique fracture.
• Segmental fracture.
• Hairline fracture.
• Spiral fracture.

For more detail on how these types of fracture differ, read ‘What’s the difference between a comminuted fracture and a transverse fracture?’.

What commonly causes humerus fracture?

There are a range of factors which can either directly or indirectly contribute to a humerus fracture. Certain causes are more likely to lead to a certain type of fracture, which in turn requires different treatment for proper healing. Knowledge of how a fracture has occurred is useful for planning an osteotomy operation.

Fall

Falling unexpectedly onto an outstretched arm, even from ground level, can result in a humerus fracture. This is a very common cause of upper extremity fracture, as our instinct is always to try and cushion our fall. Older patients or patients that regularly engage in strenuous physical activity are more likely to experience a fall which could risk fracture in the arm.

Accident or injury

An event that causes direct force or pressure to be applied to the shoulder and upper arm can result in a proximal humerus fracture. Examples include car crashes and high-impact sports injuries. The bigger the force, the larger and more complex the fracture is likely to be.

Repetitive stress

Any kind of repetitive motion that places stress on bones can make the individual more susceptible to a fracture. This is because there isn’t adequate time for the body to replace the cells. For humerus fractures, this is commonly caused by weightlifting and sports such as tennis.

Conditions

There are numerous conditions which have the side effect of weakening bones in certain parts of the body. For instance, a metabolic bone disease or bone cysts located around the scapula and upper arm.

Osteoporosis

This condition decreases bone density, resulting in weakness. Individuals with osteoporosis, especially those who have had it for an extended period of time, can suffer a fracture from even a small fall or low-impact trauma event.

Bone tumours

In rare cases, tumours on the bone itself can compromise the strength of the bone and leave it more prone to fracture. It may be necessary to treat the tumours at the same time as the fracture in order to help prevent re-fracture.

Orthopaedic products for fracture fixation

Proximal fractures of the humerus that require internal fixation and reduction must be treated with the appropriate systems. The first step in diagnosing fractures and creating a treatment plan is to investigate the injury site. The L3D Osteotomy Planning and scanning system allows for accurate mapping of internal bone structures. It then analyses the CT scan data to create virtual and physical models for pre-surgical planning. Surgeons can use these models to determine drilling locations and practice cuts ahead of time, serving as specific guides for a patient’s anatomy.

When it comes to fixing the fracture, the PANTERA Proximal Humerus Plate System is a market leading product with advanced options for cross screw fixation and the ability to achieve lesser tuberosity. Proximal humerus plate fixation using this product has been proven to be effective at anatomically reducing and stabilising the humeral head complex. The locking plate design then facilitates regular healing.

Your trusted UK orthopaedic distributor

At LEDA Orthopaedics, we understand the priorities and challenges faced in the medical sector. That’s why we’ve sought to streamline the process of acquiring products for orthopaedic surgeries by including both the system and the relevant instrumentation. This enables practitioners to deliver effective surgical treatment and high quality of care. If you have any questions regarding our elbow & shoulder products, contact LEDA and make an enquiry.

Distal radius fractures are among the most common fractures that can affect the hand and wrist. In some cases, non-operative treatments such as arm casting can be prescribed. However, in other cases the best course of action for the patient is for the fracture to be treated with surgery. This post details the surgical options available for treating those with distal radius fractures.

What can cause a fracture in the distal radius?

The most common cause of a distal radius fracture is a fall, as excessive force is placed on the wrist bones at the point of impact. It’s also possible for a fracture to occur in this area due to a sports injury or vehicle collision. The nature of the event that has caused the fracture will determine how complex it is, and at what angle the break occurs.

Surgical treatments for distal radius fractures

Owing to the skill and technology used by modern healthcare professionals, there are a number of different surgical treatments for distal radius fractures. As each can carry different contraindications and potential risks, it’s important that surgeons select the right treatment option for the patient.

Volar plating

Inserting a purpose-built orthopaedic plate with open reduction and internal fixation (ORIF) is a popular method for fracture treatment. The GEMINUS Distal Radius Volar Plate from Skeletal Dynamics has a contoured design that adheres to a range of patient anatomy. This allows the implant to achieve effective fracture reduction with minimal risk of complications with surrounding soft tissues.

For highly comminuted fractures at the distal radius, surgeons can use the COBRA Distal Radius Hemiarthroplasty prosthesis. This radial implant is intended to restore stability at the fracture site.

Dorsal plating

Surgery to implant dorsal plating follows a largely similar approach to that used for volar plating. However, this treatment is frequently used to treat complex fractures with fragment specific plates. Devices such as that included in the PROTEAN system, follows a modular design to achieve fixation of each individual bone fragment.

External fixation

This procedure involves placing pins into the bone that then extend beyond the surface of the skin. An external frame is then used to stabilise the bone and limit movement for healing. Variations of external fixation can be implemented depending on the patient’s situation. For instance, the frame fixator can extend across the wrist to keep it completely static, or it can feature a hinge to allow basic joint motion.

Orthopaedic solutions for radius fractures

LEDA Orthopaedics is a leading UK distributor supporting surgeons in providing treatment options for fractures of all kinds. We recognise that fractures are among the most common injuries that can be sustained people of all ages, especially in the upper and lower extremities. That’s why we’re partnered with leading orthopaedic suppliers from around the world. Contact us today and we’ll be happy to discuss how the needs of your facility can be met.

Arthritis is a condition that is likely to affect many of us in our lifetime, especially as we get older. A Versus Arthritis study from 2023 reports that there are roughly 10 million people in the UK living with osteoarthritis, with an estimated 350,000 being diagnosed with the condition each year. Given that osteoarthritis is more problematic when it affects joints that see regular use, let’s examine the treatment options available for osteoarthritis of the hand and wrist.

Defining wrist osteoarthritis

Osteoarthritis in the wrist causes the soft tissue lining the joints to break down. When this happens, the cartilage can no longer serve its protective function and the two ends of bone begin to rub together (distal radius/ulna and scaphoid/lunate/triquetral). The result can be pain and stiffness at the affected area, along with potential loss of movement and bone deformities. Arthritis in any form is also one of the main contributing factors in upper and lower extremity fractures, such as a distal radius fracture. Read ‘Common causes of upper extremity fractures’ for more information.

What’s the difference between arthritis and osteoarthritis?

Osteoarthritis is a degenerative form of arthritis which is caused by wear and tear from excessive use of the affected joints. It is also the most common type of arthritis. While there are many more types of arthritis that can affect the bones in the hand and wrist, the other common types include Rheumatoid arthritis and Psoriatic arthritis.

What areas does hand osteoarthritis commonly affect?

Although osteoarthritis is common in the hand due to the number of different bones, it rarely affects all parts of the hand and wrist equally. Instead, it most often affects the following joints in the hand:

• The distal interphalangeal joint (DIP joint).
• The proximal interphalangeal joint (PIP joint).
• The trapeziometacarpal joint (TMC joint).
• The carpometacarpal joint (CMC joint).
• The tri-scaphoid joint (STT joint).

Treatment options for osteoarthritis of the hand and wrist

At the time of writing, it is still unclear what the root cause of osteoarthritis is. However, medical professionals like LEDA are aware of the factors that can make an individual more susceptible to hand and wrist osteoarthritis. This includes a patient’s age, weight, injuries, hobbies, sex, genetics, and any underlying joint health problems. Fortunately, there are many treatment options both orthopaedic and non-orthopaedic that surgeons may employ in cases of osteoarthritis.

MAIA CMCJ Replacement

One of the key areas in the hand that is susceptible to osteoarthritis are the carpometacarpal and trapeziometacarpal joint at the base of the thumb where it meets the wrist. This orthopaedic device from Group Lépine is a surgical treatment designed to restore motion and provide stability to the thumb. It consisted of a cup, neck, and stem which, when implanted, connect the two ends of bone at the joint. This is an osteotomy procedure as small pieces of bone at the joint must be removed to allow for the implantation of the MAIA device, which serves as a thumb joint replacement.

INCA STT Prosthesis

In cases of scaphotrapeziotrapezoid osteoarthritis, surgeons can use the INCA STT prosthesis for lasting treatment. The implant has been designed anatomically to make sure it fits perfectly with the anatomy of the patient’s joint surfaces. Stability is then encouraged through the stem shape, thereby requiring standard instrumentation to complete the procedure. This device can also achieve cementless fixation due to its double coating of porous titanium.

IMPLATE Wrist Arthrodesis Nails

The IMPLATE system from Skeletal Dynamics is intended for intramedullary wrist arthrodesis to restore strength and dexterity to the hand and wrist. This is an ideal treatment following a range of arthritis symptoms, including rheumatoid deformities, carpal instability, unremitting wrist pain, post septic arthritis, and more. A wrist arthrodesis plate such as this is effective at achieving. While the surgical technique for this implant contains more steps than most other hand and wrist orthopaedic devices, it can be the best option for patient quality of life. As well as osteoarthritis symptoms, IMPLATE can be used to treat trauma injuries (fractures) and congenital deformities.

Physical therapies

If it’s deemed the best course of action, there are a range of non-invasive treatment options for hand and wrist arthritis in the form of hand osteoarthritis exercises. These should focus on gentle movements that improve range of motion and help alleviate arthritis symptoms. Although the exact type of exercises prescribed will vary depending on the joints affected by the condition in that patient.

Orthopaedic devices for the treatment of osteoarthritis

LEDA Orthopaedics is a leading UK orthopaedic distributor committed to helping healthcare professionals deliver great patient outcomes. To this end, we work with suppliers all over the world with a focus on both the upper and lower extremities. One of the key areas these treatments target is osteoarthritis in the hand and wrist, as we know how many people it affects. Contact us to discuss our range of treatment options. Equally, if you are looking for one of our suppliers, we’re always happy to pass details over and establish working relationships.

Osteoarthritis is a common form of arthritis that affects millions of people in the UK. It can affect a range of bones in the body but tends to affect bones at key joint locations most heavily. As a result, osteoarthritis in the hand is very common due to the number of the bones and the frequent use that these joints see. This article discusses the main points around basal thumb osteoarthritis, including possible complications and treatment options.

What are the symptoms of thumb osteoarthritis?

The basal thumb joint is located where the bottom metacarpal bone of the thumb meets the trapezium bone in the wrist. This joint is vital for the use of the thumb as it’s involved in any movement of the digit. Osteoarthritis affecting the basal thumb joint can manifest in any of the following symptoms:

• Diminished ability to twist, bend, grip, or pinch using the thumb.
• Pain and swelling localised to the thumb and the surrounding area.
• Loss of strength and movement that extends to the wrist.
• In extreme cases, a bump at the base of the thumb caused by hyperextension of the MCP joint.

What causes basal thumb osteoarthritis?

At the time of writing, there is not a consensus on what causes arthritis in all its forms. However, there are a number of factors which are recognised as being contributary to the development and worsening of the condition. For osteoarthritis that affects the base of the thumb, this includes:

• Patient age.
• Height and weight (body mass index).
• Jobs and hobbies (repetitive stress).
• Certain metabolic diseases.
• Biological sex.
• Recent injuries or those with lasting repercussions.

Healthcare professionals should consider these factors when assessing whether a patient’s symptoms could be linked to osteoarthritis. This is also necessary to judge the severity of the condition and schedule appropriate treatments. Depending on the person, certain treatments could carry significantly more risk than they would otherwise. One of the most impactful effects of osteoarthritis is that it can be reduce bone stock and weaken joints. This leaves the patient more susceptible to bone injuries such as fractures, which can make it difficult to conduct osteotomies.

Treatment options for basal thumb osteoarthritis

As we’ve established, osteoarthritis in the thumb can cause significant disruption to someone’s everyday life due to the range of tasks we use our thumbs to complete on a daily basis. The following treatments are some of the options available to combat the effects of osteoarthritis in the thumb.

MAÏA Carpometacarpal Prosthesis

Joint replacement surgery can produce long lasting positive outcomes for patients. Through the removal of some or all of the thumb joint, an artificial implant can be inserted to restore motion and stabilise the thumb at the base. The MAÏA prosthesis from Group Lépine consists of a trapezial cup, offset neck, and metacarpal stem. Its dual mobility design is effective at reducing the chance of dislocation and ensuring stability. This system also comes with modern cannulated instrumentation to aid in surgical application.

Arthrodesis

Pain can be relieved by fusing joints in the thumb together. This can be achieved through the precise shaping of the trapezium and the hollowing of the metacarpal bone. Once the bone ends fit flush against each other, metal pins are used to hold the bones in place and allow them to knit together. It should be noted that this has the potential to be a lengthy open surgical procedure and so carries a relatively high complication rate. Although expertise and the use of leading arthrodesis screw and nail technology can reduce risk.

Movement restrictions

Efforts to limit movement and maintain positioning of the thumb can allow joints to repair themselves. A common way to do this, whilst also providing support and protection to the joint, is through the use of a hand or wrist splint. Although a medical professional may have to set the bones in the correct position first. They can also recommend exercises to help strengthen joints and improve function.

However, this treatment option may not be viable for every instance of osteoarthritis. For instance, a complex fracture could prevent blood flow from reaching the basal thumb joint thereby not allowing the bones to heal and making a splint an ineffective treatment.

Your UK orthopaedic distributor         

If you’re looking for a trusted third party to supply your clinic or hospital with arthritis implants, LEDA Orthopaedics can help. Our company is in collaboration with leading global suppliers of specialist orthopaedic implants for the treatment of osteoarthritis. Contact us and a member of our team will be happy to discuss how your needs in healthcare provision can be met.

An osteotomy of the ulna designed to shorten the bone can have many long-term positive patient outcomes. One of these is the removal of wrist pain and the restoration of a full range of movement in the joints of the hand and wrist. Surgeons should be aware of the pros and cons of an ulna shortening procedure so they can accurately advise patients on the treatment options which are best for them.

Causes of wrist pain in adults

Ongoing wrist pain that doesn’t go away can have a significant impact on someone’s quality of life. This is because the wrist typically flexes, undergoes strain, and carries weight on a regular basis. Pain in the wrist can also directly impact any actions that involve precise hand movements. The following are some of the most common causes of wrist pain in adults:

• Fracture or sprain due to a sudden impact.
• Repetitive stress or other long-term conditions such as carpal tunnel or arthritis.
• Ulnar impaction syndrome. This causes the ulna to be longer than the radius, resulting in occasional contact with some of the smaller bones in the wrist.

In most cases, wrist pain is accompanied by swelling, redness, or loss of movement and grip strength which can make it easier to diagnose. With ulna wrist pain specifically, a clicking sound can also accompany movement as the bones come into contact.

What is the process of ulna shortening?

As the name suggests, the purpose of ulnar shortening osteotomy is to reduce the length of the ulna. This can result in a tightening of the triangular fibrocartilage complex (TFCC), interosseous membrane, and ulnocarpal ligaments. These outcomes are desirable as they can help remove the risk of the ulna interfering in the wrist joint in cases of ulnar impaction syndrome. This procedure can also reduce the amount of load that goes through the ulnar side of the wrist compared to the radius side, thereby reducing the likelihood of wrist pain returning in the future.

The first step in an ulna shortening procedure is to check that it is safe to conduct. Once all the necessary safety measures have been taken and proper instrumentation is prepared, it can follow these broad steps:

• An incision is made to gain access to the ulna. Then a predetermined section of bone is removed to shorten it. This osteotomy can be done at either the distal or proximal end of the ulna.
• The two pieces of bone must then be pulled together, ensuring the ulna is now in a favourable position.
• Lastly, a forearm and wrist plating implant and orthopaedic screws must be applied to fix the bones in position. If the patient has suffered a fracture, this plate will be inserted at the fracture site. Otherwise, it will be positioned to provide maximum stability to the arm and wrist.

For more detail on the surgical procedure of ulna shortening, see Skeletal Dynamics’ Ulna Shortening System or the surgical procedure for the FREEFIX Forearm Plating System.

Ulna shortening as a treatment for wrist pain

An ulna shortening procedure should only be sought once more conservative treatment options for wrist pain have been exhausted. Examples include physical therapy or changing habits. When these fail, it will usually confirm the presence of an ulna bone that is pressing excessively on the wrist. The ulna shortening procedure is then more likely to result in long-term relief from wrist pain.

Specialised orthopaedic systems such as the FREEFIX Ulnar Shortening System give surgeons the flexibility to address patient specific pathologies. This device comes with options for both proximal and distal osteotomies, as well as accommodating compression screws and locking screws. Once internal fixation has been achieved, the ulna shortening plate maintains rotational stability in the forearm. For a more dedicated fracture reduction system, there’s the FREEFIX Forearm Plating System. This can be used to repair midshaft fractures of either the ulna or radius.

Orthopaedic devices for ulna shortening

LEDA are proud to work in collaboration with some of the leading orthopaedic suppliers across the globe in order to facilitate procedures such as ulna shortening. It’s one of our goals to bring innovations in orthopaedic surgery to the forefront of general medical use. As such, we don’t just supply devices for use in the upper extremities, we also distribute a range of implants for the treatment of lower extremity injuries complete with specialist instrumentation. This includes treatments for highly complex injuries, such as a pelvic fracture. Contact a member of the LEDA team today to get started.

Fractures in the forearm can be highly detrimental to patient quality of life as it impacts the ability to complete everyday tasks. As healthcare professionals we must therefore continue to provide effective treatment that will get the best results for the patients in our care. This means taking into account the severity of the fracture, patient anatomy, and anything in their medical history that could be a concern. In this article, we explain the various ways in which forearm fractures can be fixed.

Diagnosing a forearm fracture

A fracture in the forearm can affect the radius bone, the ulna bone, or both. Additionally, the nature and location of the fracture will need to be established. This is because different bone fractures require different approaches to treatment. For instance, a complex radial head fracture will require more extensive work to fix than a simple hairline fracture towards the middle of the bone. We discuss in greater detail the different methods for fixing a forearm fracture below.

The recent research ‘Insights and trends review: the role of three-dimensional technology in upper extremity surgery’ attests to the importance of 3-D technology in upper limb procedures. Detailed internal mapping images like those produced by L3D Osteotomy Planning technology gives surgeons the ability to accurately predetermine many key actions that will be taken in the procedure. This includes the location of incisions, which cuts need to be made, and the instrumentation that’s best suited to the procedure. The guides that are created specific to the patient’s anatomy, greatly increasing accuracy.

Ways to fix a forearm fracture

When a patient comes in exhibiting signs of a forearm fracture and once it has been assessed, practitioners must then construct a treatment plan. If this includes surgery, L3D Osteotomy Planning technology is now available to help simulate surgical solutions for upper extremity fractures. By creating detailed and accurate models of the patient’s anatomy, surgeons are able to plan procedures holistically. As mentioned, the treatment used will depend on a range of factors which the surgeon must consider.

Open reduction and internal fixation (ORIF)

Complex forearm fractures typically require a surgical procedure where the bone is accessed directly through an opening made in the skin. Hardware is then implanted at the fracture site to stabilise the two ends of the bone and maintain proper alignment for healing. The FREEFIX Forearm Plating System has been designed to mimic callus formations and strengthen the forearm bones following fixation. Medical professionals can use this product for dynamic compression on both the radius and ulna. Another option is the GEMINUS Distal Radius Volar Plate. This system is designed for the added fixation of marginal fragments and the protection of tendons.

In rare cases, external fixation may also be used to achieve healing in the bones of the forearm. This is typically only recommended in instances where internal devices are hindered by the presence of swelling or other soft tissue damage.

Casting

A healthcare professional may be able to use closed reduction to manipulate bones without the use of surgery. Achieving alignment in this way is typically only possible in cases where there hasn’t been significant bone displacement. A medical grade cast or elbow splint such as the Jake Design eXo Elbow Splint will then need to be worn for a number of weeks to promote healing.

Intramedullary nailing

Metal rods are inserted into the fractured bone to provide stability at the fracture site. This is not regularly used unless the fracture has occurred in the shaft of the radius or ulna.

Physical therapy

Depending on the nature and severity of the injury, non-surgical treatment options can be available. Various exercises may be recommended to restore range of motion to the forearm and allow the limb to return to full usefulness. A healthcare professional will advise the patient on when exercises should start and which ones they should do to help aid in recovery. Each patient’s rehabilitation process will differ based on the type of forearm fracture they received, as well as any underlying health conditions.

European and UK orthopaedics distributor

LEDA Orthopaedics stocks a range of instrumentation and systems for the treatment of fractures across the body. This includes fractures to the lower extremities, clavicle, hand, and pelvis. All the suppliers we work with are pioneers in the field of orthopaedics, implementing technologies that improve efficiency and delivery better results. Contact us to speak with a member of our team. We pride ourselves on being a trusted provider of niche trauma implants and innovative prostheses.