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. 2023 Sep 22;6(4):e286.
doi: 10.1097/OI9.0000000000000286. eCollection 2023 Dec.

Management of complex wrist fractures with volar and dorsal locked (double-locked) K-lock

Prieur du Plessis  1 , Marie-Cecile Fournier  2
Affiliations

Management of complex wrist fractures with volar and dorsal locked (double-locked) K-lock

Prieur du Plessis et al. OTA Int. .

Abstract

This article is a technical note to outline a novel technique of fixation in complex, comminuted distal radius fractures using a double-locked K-wire construct using a new implant called K-lock. In these (AO) C-type fractures, with significant dorsal comminution, it is often difficult to attain stable and secure fixation of the dorsal rim fragments, especially the dorsal lunate fossa fragment. This often results in patients being treated by temporary spanning devices or asking to have a restricted use of the hand during a given period to avoid loss of position. If dorsal plating is necessary, because of the severity of the comminution, a double-locked K-wire (locked in both the dorsal and volar plates) offers a fixation option and may create a significantly stronger construct and allow confident early mobilization. The K-lock was recently launched by Newclip Technics as an adjunct to the Xpert Wrist 2.4 set as a fragment-specific fixation option. The wire has less chance of displacing or fracturing the fragment and has a smooth surface compared with a screw; this wire would be safer close to the joint in severe distal intra-articular comminution. Of the 9 cases performed so far (as is our usual practice), despite the complexity of the fractures, none were immobilized postoperatively and all started hand therapy in the first week. Most were driving by 2 weeks and returned to light work at 4 weeks and heavy work or sports at 6 to 8 weeks. This principle of fixation may also be extended to other fractures where dual plating is used.

Keywords: distal radius fracture; dual approach; fracture specific; volar locking plate.

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Conflict of interest statement

P.d.P. is consulting for Newclip Technics. M.-C.F. is a paid employee of Newclip Technics.

Figures

Figure 1.
Figure 1.
Sagittal CT scan showing dorsal comminution obtained from 2 patients.
Figure 2.
Figure 2.
Anteroposterior view of a conventionally used K-lock.
Figure 3.
Figure 3.
Lateral view of a conventionally used K-lock.
Figure 4.
Figure 4.
Presentation of the K-lock system.
Figure 5.
Figure 5.
Intraoperative X-ray with a couple of temporary fixation wires, the clamp in place, and the K-lock advanced through both dorsal and volar plates.
Figure 6.
Figure 6.
Anteroposterior view of the final construct with fluoroscopy.
Figure 7.
Figure 7.
Lateral view of the final construct with fluoroscopy.
Figure 8.
Figure 8.
3D illustration of the final construct (global view).
Figure 9.
Figure 9.
3D illustration of the final construct (focus on the fracture at the distal radius).
See this image and copyright information in PMC

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