A very novel lever action plate system for distal radius fractures has reached the important, first-in-man milestone.
First-in-Man Lever Action Plate System
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#distalradiusfracture#leveractionplatesystem
Developed by McGinley Orthopedics in partnership with Shriners Hospital for Children in Philadelphia, the system’s fragment reduction helps surgeons restore volar tilt and articular congruity. It allows for easier alignment of complex wrist fractures with just a simple twist of a dial.
Dr. Dan Zlotolow was the first to identify the need for this technology and worked with the engineering team at McGinley Orthopedics to develop the system.
He was also the first surgeon to use it on a patient at Shriners. He said the surgery was a success and that “the ability to dial in the volar tilt is a game changer.”
The Lever Action Plate System which can be used for a wide range of distal radius fractures allows for more precise reduction of fracture. It received FDA clearance in June 2020.
Traditional volar plating has a 15% complication rate. Imprecise alignment can lead to traumatic arthritis and the need for further surgery. The new plate system gives surgeons the ability to precisely adjust the alignment of the broken bone fragment.
The system “features proprietary subchondral beams that dynamically align volar tilt,” according to McGinley Orthopedics.
“The beams are used to elevate the mal-reduced fracture fragments with the turn of a screw to the surgeon’s desired position. Optimizing alignment, the beams provide independent fixation of the central and radial column. The beam’s contoured design provides subchondral fixation to reduce subsidence.”
It also has optional variable angle screws of different sizes. The plate is designed to sit just proximal to the watershed line on the distal radius. The system is used in combination with the IntelliSense Drill Technology which has an auto-stop feature that allows for more accurate screw sizing.
Surgeons can check out the Lever Action Plate System at the 2021 annual meetings of the American Academy of Orthopedic Surgeons and the American Society for Surgery of the Hand.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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