The Treatment of Distal Radius Fractures

using Axior Distal Radius Plating System

A BRIEF REVIEW
Introduction
The treatment of distal radius fractures
using locking plate system is common
today. This brief review provides an
insight to the design features, benefits
and clinical outcome of the treatment
of distal radius fractures using the Axior
Distal Radius Plating System. In 2012,
Leonix launched Axior Distal Radius
Plating System (ADPRS); since then, the
ADPRS has achieved promising results.
Leonix is pleased to share the success
stories within this review.
AO Principles

Fracture fixation
providing
Fracture absolute or
reduction to
relative stability
restore
as the personality
anatomical
of fracture,
relationships.
patient and
injury requires.

Early
and safe
Preservation
mobilization
of blood
of the
supply to
injured part
soft tissues
and the
and bone.
patient as
a whole.
Overview of
Axior Distal Radius
Plating System
Axior Distal Radius Plating System features a
comprehensive plates design indicated for various
scenarios such as intra and extra articular distal
radius fracture, capital and subcapital ulna fractures.
The plates and various type of screws are housed
in a modular graphic case to accommodate a set of
intuitive surgical instruments which provide surgical
convenience, improve surgical performance and
reducing OR time.

PLATES
• Anatomic volar distal radius locking plate
for fragmentary fractures
• Distal Radius locking T-plate
• Distal ulna duo-claws locking plate

SCREWS
• Locking screws 2.4 mm for the head screw holes
(metaphyseal bone)
• Locking screws 2.7 mm for the shaft screw holes
(diaphyseal bone)
• Threaded peg 2.7 mm for the shaft and
head screw holes (Osteoporosis bone)
• Cortex screws 3.5 mm for oblong hole
(compression screw)
 Anatomic Volar Distal Radius
Locking Plate

Oblong hole allows 5mm

longitudinal translation of plate

Rounded plate
Design Rationale
end for easy Gourd shaped hole for ease
percutaneous
insertion
of bone graft insertion
& Benefits
K-wire hole for temporary The Axior Distal Radius Plating System design
Limited contact base reduces fixation of plate
plate-to-bone contact that
features an optimum anatomical fitted plate that
preserves vascularization comes with a set of effective screw trajectories.
Highly polished round The comprehensive choice of screws design
plate edges and
surfaces reduce soft provides well suited requirements for various
Converging proximal
screws provide secondary
tissue irritation bone characteristic. These features fulfil the
subchondral support and biomechanical and clinical needs to obtain the
maximizing fixation stability results guided by AO principles. Its’ biomechanical
Optimized screw trajectories strength were computationally analyzed and
provide maximum support
for radial styloid, lunate experimentally tested.
facet and DRUJ

Distal Radius
Locking T-Plate
Adequate number of
Oblong hole allows 5mm Anatomically fitted design
screw holes and optimised
longitudinal translation of plate to facilitate placement of
trajectories at the head
plate to bone to achieve
portion to enhance the
low profile fixation and
fracture fixation at the
Pear shaped hole for ease reduce soft tissue irritation
metaphyseal bone
Bevelled plate edge of bone graft insertion
for reduction of
tendon irritation
and abrasion
Optimized plate design Comprehensive screw
to provide a well suited design to address secured
The gradient radius
Limited contact base stiffness and stability of purchasing of different
thinning head parallel to
reduces plate-to-bone the bone-plate construct bone characteristic
the watershed line avoids
contact that preserves
prominence and reduces
vascularization
discomfort and soft
tissue irritation
Superior Titanium
alloy material supports Limited contact shaft
K-wire hole for
Optimized screw trajectories Biomechanically stabled profile on the underside
temporary fixation
of plate provide maximum support fixation to promote facilitate blood supply
for radial styloid, lunate bone healing
facet and DRUJ
Clinical Cases
OVERVIEW
A clinical study was carried out between
April 2012 to November 2014. In this study,
post-operative outcome were followed up
for patients with a selection criteria of at
least three months post-operation. A total
of 46 patients post operative outcome were
evaluated. Out of 46 patients, 29 were male
and 17 were female with mean age of 38
(range: 17 - 67) years old.
 TYPE OF FRACTURES CASE 1 Male 54 years old
All of the 46 patients were having a distal radius Fracture type : 23-B3
fracture due to the motor vehicle accident and a fall with Injury cause : Falling
outstretched hand. The fracture type were classified Implant Removal : 48 weeks post-operative
with AO Classification where 54% of the fractures with
type 23-B, 38% with type 23-C, and 8% with type 23-A.
92% of the fractures were located at the metaphysis
of the distal radius bone. The patients were treated
with Axior Anatomic Volar Distal Radius Locking Plate.

PRE-OPERATIVE
AO Number Extra 23-A1 23-A2 23-A3
classification of cases articular ulna, radius, simple radius,
radius intact and impacted multifragmentary

23-A1 3

IMMEDIATE POST-OPERATIVE
23-A2 1

23-A3 1

AO Number Partially 23-B1 23-B2 23-B3

classification of cases articular radius, radius, frontal, radius, frontal,
sagittal dorsal rim volar rim

23-B1 1

23-B2 8

23-B3 15

IMPLANT REMOVAL (48 WEEKS)

23-B1 23-B2 23-B3
AO Number Complete simple, simple, multifragmentary
classification of cases articular metaphyseal metaphyseal
simple multifragmentary

23-C1 6

23-C2 9

23-C3 2
CASE 2 Male 60 years old CASE 3 Female 81 years old
Fracture type : 23-C1 Fracture type : 23-A2
Injury cause : Falling Injury cause : Falling
Union : 5 weeks post-operative Wrist full function : 33 weeks post-operative

PRE-OPERATIVE

PRE-OPERATIVE
IMMEDIATE POST-OPERATIVE

IMMEDIATE POST-OPERATIVE
WRIST FLEXION-EXTENSION
UNION (5 WEEKS)
 CASE 4 Male 27 years old CASE 5 Female 45 years old
Fracture type : 23-B3 Fracture type : 23-B3
Injury cause : Motor vehicle accident Injury cause : Motor vehicle accident
Union : 11 weeks post-operative Union : 20 weeks post-operative

PRE-OPERATIVE UNION (11 WEEKS) PRE-OPERATIVE UNION (20 WEEKS)

WRIST FLEXION-EXTENSION
WRIST FLEXION-EXTENSION
CASE 6 Male 20 years old CASE 7 Female 50 years old
Fracture type : 23-A2 Fracture type : 23-A2
Injury cause : Motor vehicle accident Injury cause : Quick slipping and falling
Implant Removal : 20 weeks post-operative Union : 8 weeks post-operative

PRE-OPERATIVE

PRE-OPERATIVE
IMMEDIATE POST-OPERATIVE

UNION (8 WEEKS)
IMPLANT REMOVAL (2O WEEKS)

WRIST FLEXION-EXTENSION
CASE 8 Male 56 years old CASE 9 Male 24 years old
Fracture type : 23-B3 Fracture type : 23-A2
Injury cause : Falling Injury cause : Motor vehicle accident
Union : 8 weeks post-operative Union : 13 weeks post-operative

PRE-OPERATIVE

PRE-OPERATIVE
IMMEDIATE POST-OPERATIVE

POST-OPERATIVE (3 WEEKS)
WRIST FLEXION-EXTENSION

UNION (13 WEEKS)

 CASE 10 Male 36 years old RANGE OF MOTION AND
ANATOMICAL MEASUREMENTS
Fracture type : 23-C2
Injury cause : Motor vehicle accident The range of motion and anatomical
Union : 14 weeks post-operative measurements of the DRUJ were evaluated
between 10~20 weeks follow up. The X-ray
scans for 45 cases (97%) shows good results
with anatomical measurement within that
of a healthy bone. The wrist function was
assessed for all 46 patients and the range of
motion were found to be acceptable.

Extension Flexion

Natural range
60 45
in healthy bone

Mean value 43 38

Range 15-60 20-45

PRE-OPERATIVE P0ST-OPERATIVE (6 WEEKS)

Extension

Flexion

UNION (14 WEEKS)

 Supination Pronation Volar Tilt

Natural range Natural range

90 80 3-8
in healthy bone in healthy bone

Mean value 84 78 Mean value 5.5

Range 45-90 45-80 Range 0-15

Volar tilt

Pronation Supination

Radial Radial Ulnar FUNCTIONAL SCORES

Inclination Height Variance All 46 patient’s wrist pain and functional score
Natural range were evaluated using patient rated wrist evaluation
15-25 8-15 0-2
in healthy bone (PRWE) and disabilities of the arm, shoulder,
and hand (DASH) score questionnaires. The post
Mean value 18 11 0.3
operative functional scores were found to be within
Range 5-28 3-15 0-5 good range. The mean PRWE score was 11 which can
be considered mild pain with good functional results.
The mean DASH score is 8 which shows that the
patients can perform general and specific activities
without any problem.

B C
Functional Score Overall Score
A
PRWE Score 11

A Ulnar varianace
DASH Score 8
B Radial inclination
C Radial height
Techniques & Tips
The Axior anatomic distal radius plate anatomy is found suitable
for the treatment of fractures at the distal metaphysis of the
radius bone. In some cases, the fracture occurs toward the radial
or medial column. The presence of 6 screw holes distributed on
the distal head portion of the plate and various screw lengths
allow optimum purchase of the bone fragments for the radial or
medial column. Optimum screw trajectories construction enables
the plate to maneuver freely between the radial or medial
column in larger bones to provide effective fixation of the radial
fragment particularly the radial styloid, and maximum support to
the medial column around the DRUJ.
Conclusion
This clinical study shows that Axior Anatomic Volar Distal Radius
Locking Plate was found to be an effective plate to treat the
metaphysis and diaphysis fractures of the distal radius bone.
The plate width was found suitable to secure the fragments at
the radial and median columns, nevertheless, the surgeon has
an option to place the plate closer to median or radial column to
secure the small fragment in larger bones. In all the cases within
this study, a good union was achieved. There were no complications
of and implant failure, screw loosening, or other unsatisfactory
results which were associated to the implant. From the 46 cases
within the study, the wrist function was restored without problem
for general daily activities for all the patients and specific activities
such as lifting heavy objects in 40 patients.

Axior

1. Optimum
bone-plate stiffness

2. Suitable for Intra-

Extraarticular fracture fixation

3. Excellent Support for the radial

and median columns

4. Effective for metaphyseal

fragmentary fixation

5. No complication associated with

the Axior Plating System

6. Appropriate for various bone mineral densities

from normal to osteoporotic bone

7. Early active mobilization

 Anatomic Volar
Distal Radius
Locking Plate
Adopting the locking technology,
the unique Anatomic Volar Distal
Radius Locking Plate System
was designed to treat complex
distal radius fractures.
Distal Ulna Duo-Claws
Locking Plate
The novelty of this Distal Ulna Duo-Claws
Locking Plate lies within the function of
the flexible thin claws that are capable
of capturing even very small ulna styloid
fragments which were not feasibly
secured by screw, peg or wire.

Distal Radius
Locking T-Plate
For simplicity, the Distal Radius
Locking T-Plate System was
designed to treat simple
2 to 3 fragments distal
radius fractures.
One System. Multiple Solutions.
Leonix Sdn Bhd
0086
No.9 Lintang Beringin 10, Diamond Valley, 11960 Bayan Lepas, Penang, Malaysia MD 585201
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