PROXIMAL ULNA PLATE Surgical Technique Guide
September, 2023
FREEFIX® Ulnar Shortening System
Features
- Distal and proximal options to address specific pathology
- Undercuts to allow saw blade clearance
- FREEFIX slots accommodate locking or compression screws at a range of positions
The Ulnar Shortening System
This system can be used in either distal or proximal osteotomy. In the former, metaphyseal application can maintain regular distal interosseous ligament tension. In the latter, the system enhances distal interosseous ligament tension to stabilize the distal radial ulnar joint (DRUJ). Ulna shortening typically happens with the help of a hand plating system, as it’s a method for treating wrist pain.
The titanium alloy plates of the system are also designed for fracture fixation and non-unions of the ulna. It is used in methods of internal fixation to stabilize areas, allowing bones to reknit correctly.
The FREEFIX Ulnar Shortening System includes:
- Distal Ulnar Shortening Plates (available in left and right configurations)
- Proximal Ulnar Shortening Plates (available in two lengths)
- Locking and non-locking titanium screws
- K-wires for provisional fixation (not to be implanted)
- Specialized instrumentation (threaded locking and non-locking pegs, forceps, pliers, gauges)
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Distal and proximal cutting guides allow blade access from either side of the plate
Streamlined procedure that maintains rotational stability
Apply the plate to the bone with the proximal screws in the most proximal slot position.
Slide the cutting guide to the most distal position and secure with a k-wire(s). Perform the first cut.
Slide the cutting guide proximally to the desired shortening length and resecure with a k-wire(s). Perform the second cut and remove the cutting guide.
Remove the bone wedge, loosen the slot screws and compress the fragments using the compression forceps.
Retighten the most distal slot screw while maintaining compression with the forceps.
Remove the compression forceps, retighten the proximal slot screw and place the final screw in the most proximal hole.
This pioneering system from Skeletal Dynamics is part of the Geminus range that also includes
GEMINUS® Distal Radius Volar Plate
Pioneered by Dr Jorge Orbay, MD, volar plating has dramatically reshaped the treatment of distal radius fractures.
PROTEAN® Fragment Specific Plates
The Geminus range of fragment-specific plates works to repair fractures of the intermediate and radial columns in complex cases where surgery is required.
Founded in 2007 by Dr Jorge Orbay, MD, Skeletal Dynamics set out to provide innovative, science-based solutions to solve and understand the clinical challenges of upper extremity surgery and unmet clinical needs. Skeletal Dynamics is the only medical device company that is 100% solely focused on the upper extremities. Distributors of Skeletal Dynamics are selected based on individual integrity, industry experience and clinical knowledge and LEDA is proud to be the leading UK orthopaedic distributor for Skeletal Dynamic products including:
Frequently Asked Questions
A proximal osteotomy removes a thin piece of bone from the proximal ulna below the elbow joint. The two pieces of bone are then brought together and fixed using plates and screws. This operation shortens the length of the ulna. As the radius retains its length, this reduces the stress exerted on the ulnar side of the wrist.
Proximal and distal osteotomies share the same method of removing a small piece of bone. However, they differ in where they make the cut and as a result, where the plating is located. A distal osteotomy procedure makes the surgical cut further up the forearm, closer to the elbow joint.
An appropriate saw blade should be sourced by the healthcare facility. The system does not include this instrument. Here is the list of suggested saw blades for the ulnar shortening plating system:
- Stryker – CORE/CORE 2/F1 System/SABO Saw Series
- Conmed Linvatec – MicroFree, MicroPower, MicroPower+
- Conmed Linvatec – Hall 50 Sagittal Saw
- Synthes – Small Battery System/TRS
- Synthes – Electric Pen Drive
- Arthrex – All Systems Small Bone Saw
- SNN – Dyonics Power Small
- MicroAire – Series 5000
More saw blade information can be found on page 23 of the surgical technique.