Introduction This paper will describe the surgical technique for the treatment of unstable distal radial fractures with use of the MICRONAIL Intramedullary Distal Radius System (Wright Medical Technology, Arlington, Tennessee).
Step 1: Closed Reduction and PinningThe fracture must be adequately reduced and pinned prior to nail insertion.
Step 2: Perform Exposure and Enter CanalProtect the branches of the superficial radial sensory nerve at all times.
Step 3: Insert Nail and Distal Locking ScrewsInsert the nail to a depth to place the most distal screw just proximal to the radiocarpal joint line; confirm fluoroscopically that the screw does not penetrate the articular surface.
Step 4: Insert Proximal Interlocking Screws and CloseConfirm that the proximal interlocking screws are bicortical for adequate fixation but are not too long.
Step 5: Postoperative Management Use of a splint is followed by active and then passive range-of-motion exercises.
Results We reported a prospective analysis of patients treated for an unstable distal radial fracture with an intramedullary nail.
What to Watch For Indications
Pitfalls & Challenges
This paper will describe the surgical technique for the treatment of unstable distal radial fractures with use of the MICRONAIL Intramedullary Distal Radius System (Wright Medical Technology, Arlington, Tennessee).
There are a variety of options for treating unstable distal radial fractures, including closed reduction and casting, percutaneous pinning, external fixation, and open reduction and internal fixation (ORIF); each has its own advantages and potential complications1-17. Despite the increased utilization of locked volar plating, soft-tissue complications persist. Recently, intramedullary nailing has been introduced to minimize soft-tissue complications while providing stable internal fixation18.
With the MICRONAIL Intramedullary Distal Radius System (Fig. 1), the nail is inserted through the radial styloid without cutting any muscle or the periosteum around the fracture site, thereby …
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