The Viper™ Plate addresses distal radius
fractures (and osteotomies) in a few
simple steps:
1. A palmar radial flexor carpi radialis (FCR)
approach is used
2. The fractures are reduced
3. The plate is applied on the palmar aspect of
the wrist in an optimal position for support of
the fracture fragments in an anatomical position
4. The plate is held in an optimal position with
K-Wires and a proximal cortical screws
5. The distal VALT Screws are oriented to maximize
bone purchase and lagging of fracture fragments
6. After all VALT Screws are appropriately seated
in the plate distally, the locking Viper Key is
used to lock the distal screws. Then the proximal
screws are applied
7. Finally, the bone graft is applied if indicated
Note: Fluoroscopy should be used repeatedly throughout
the procedure to confirm adequate fracture reduction
and proper positioning of the plate and screws.
Surgical Approach
After surgical site is sterile, prepped and
draped, under tourniquet control, a palmar approach
to the distal radius is made through an extended
flexor carpi radialis tendon sheath incision
(Figure 1)
Start the incision 1cm distal to the wrist flexion
crease at a 45º angle to the wrist
Progress the incision proximally for approximately
8cm overlying the FCR
Open the FCR tendon sheath and retract the FCR
tendon and medial nerve ulnarly with the radial
artery being retracted and protected radially
Visualize the pronator quadratus through the
floor of the FCR tendon sheath, and release it
from the radius distally and radially
Retract the pronator muscle proximally and ulnarly
exposing the fracture site and distal radius
Release the first dorsal compartment as well
as the insertion of the brachial radialis/ tendon
subperiosteally from the distal radius to allow
mobilization of the distal fragment
