Kendrick Lee , MD Private Practice, Oakland, California

If you compare the immediate post-op films to the one week post-op films, the dorsal ulnar corner can be seen to be displacing on both wrists. If you examine the injury films, you see the same displacement.

Figure 10 Left hand Immediate post op (on the left) and one week followup films (on the right)

Figure 10 Right hand Immediate post op (on the left) and one week followup films (on the right)

A critical review of the PA views shows that the distal locking screws did not engage the dorsal unlar fragment of the radius. Although the lunate was not yet subluxing dorsally on either hand (hit the back button to verify), this was the concern, as this is a classic failure mode of volar plating when the dorsal ulnar corner of the radius is not stabilized by the distal screws. It was felt that progressive displacement of the fragments was of concern, and that waiting would only result in both further displacement and malunion. It was decided that this needed to be addressed now.

Would you agree with this assessment? What would your plan be?

The case continues on the next page >>>

Jump to page: 1 2 3 4 5 6 8 9