LEDA Ortho

Elbow

Upper Limb Trauma Specialists

Maia

MAÏA™ Carpometacarpal Prosthesis

Established in October 2013, LEDA Orthopaedics began life as a sales agency and quickly grew into a UK and European distributor with innovative suppliers from all over the world. Founding directors David Plane and Jon Bloy have over 30 years’ collective experience in the orthopaedic industry and a passion for the sector that shines through in their commitment to the business to this day. Read More…

Our Suppliers

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Latest News

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How does ulna shortening treat wrist pain?

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.

March, 2024
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How are forearm fractures fixed?

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.

March, 2024
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Developments in compression screw technology

Compression screws are an important piece of instrumentation used in a wide range of orthopaedic surgeries. They are designed to treat bone fractures by compressing the fracture and allowing for internal fixation through the use of orthopaedic plates. Developments in compression screw technology therefore directly affect the orthopaedics industry, leading to benefits for both surgeons and patients.

In this blog, you will find information on the latest developments in compression screw technology and the benefits this brings for the orthopaedics industry.

 

History of the compression screw

Screws were first used by healthcare professionals as a pioneering treatment in the field of orthodontics. It was present in devices that resembled braces, which would rotate teeth and adjust the layout of the mouth to address dental issues such as overcrowding. Orthopaedic devices for open reduction and internal fixation started to see use towards the end of the 18th century, although we don’t know exactly how frequent or successful these procedures were. The first detailed account of internal fixation using screws and plates came in 1858. However, at this stage there were still many improvements to be made to the screws to make fixations more stable and risk-free.

It was in the 20th century that many technological advancements were made in compression screws. Developments were made steadily to improve implantation efficiency and patient experience, as well as to reduce risk. In most cases, fractures that are compressed properly lead to quicker recovery times and bones to heal in the correct way. Modern compression screws also allow orthopaedic devices to be removed more easily in instances where this course of action is recommended. Compression screw technology has only been around for the last 100 or so years. As such, there is lots of scope for further developments in this area.

 

Surgical uses of compression screws

Compression screws perform a vital role in orthopaedic surgery by aiding in bone fixation and securing orthopaedic devices. If the compression screws don’t function properly, it can compromise the effectiveness of the surgery and the patient is likely to experience potentially significant complications. Screws are typically inserted at multiple places around the fracture site to prevent the bone ends from moving, thereby allowing the bone to heal naturally.

There are a wide range of compression screw types employed by medical professionals today. These can differ based on design, features, materials, and finishes, with each typically being available in a range of sizes. Certain types of compression screw will be more suitable depending on the patient’s anatomy and the procedure being performed. The most common types of orthopaedic screws include:

  • Arthrodesis screw.
  • Cannulated screw.
  • Partially or fully threaded screw.
  • Cancellous screw.
  • Cortical screw.
  • Acutrak screw.
  • Headless compression screw.

 

New compression screw technologies

In recent years, orthopaedic screw technology has advanced to provide surgical experts with a wider range of options. As a result, healthcare professionals have greater ability to treat fractures as they possess instrumentation specific to the trauma suffered. This has come in the form of a variety of locking options and multidirectional screws. Across different fracture surgeries, this has led to screws that instil angular stability and hold firm in peri-articular fractures. Modern designs also allow for axial movement to increase fixation effectiveness, meld with patient anatomy, and reduce risk.

Compression screws are provided in most of the systems that LEDA supplies for fixation of the hand and wrist, and elbow and shoulder. However, surgeons can gain access to a range of orthopaedic screws with the REDUCT® Headless Compression Screw System. As with all the devices available on our website, we only choose to distribute orthopaedic products that utilise market leading technologies. As such, the screws possess the following attributes:

  • Headless design – allows for ease of screw implantation in areas where articulation occurs, thereby reducing risk of soft tissue damage and irritation.
  • Variable thread pitch – leads to gradual compression of the two fragments as the wider threat pitch penetrates the bone faster than the narrower threads.
  • Cannulated – facilitates more accurate screw insertion.
  • Specific materials – modern compression screws can be made from a range of materials, depending on their intended use. Common examples include Stainless Steel, Titanium, and Cobalt Chromium alloy.
  • Cutting flutes – forward facing cutting flutes for improved insertion.

It should be noted that compression screws can be provided both sterile and non-sterile. This will be stated in the system’s commercial documents, which therefore means certain devices are not recommended if your facility does not possess the means to sterilise components on site. This is important, as assessed by this recent clinical paper, the cost of care in the operating room can be influenced by the relevance of orthopaedic products.

 

Access surgical compression screws

At LEDA Orthopaedics, we take great pride in being a leading UK orthopaedic distributor. This means we are constantly aware of innovations being made that will affect orthopaedic implants, such as those in compression screw technology. We also like to take an innovative approach and work with suppliers who are working with products at the forefront of the industry. This means we are able to provide specialist orthopaedic systems and appropriate instrumentation together at short notice. Our expert team are on hand for your needs, so don’t hesitate to contact us to arrange a meeting or if you have any further questions.

February, 2024

The Founders

“When we established the company, we had one overriding goal: to provide exceptional levels of service to our customers and always enjoy what we do!”
David Plane
Managing Directors