A Simplified Method for Determining the Safe Zone in Proximal Radial Plate Fixation

Area of Science:

• Orthopedic surgery
• Anatomy

Background:

• The radial head and neck's anatomy presents challenges for plate fixation, potentially causing forearm rotation impingement.
• Existing methods for identifying safe plate placement zones have limitations.

Purpose of the Study:

• To propose and evaluate an alternative method for determining a safe zone for radial head and neck plate fixation.
• To compare this new method with established techniques for identifying safe zones.

Main Methods:

• The study utilized 30 embalmed cadavers with a full passive range of forearm rotation.
• Plates were positioned anteriorly during pronation and posteriorly during supination.
• Range of motion was assessed to detect proximal radioulnar joint impingement, and plate positions were compared to existing safe zones.

Main Results:

• All specimens maintained a full passive range of motion after plate fixation in tested positions.
• The proposed plate placement method resulted in fixation within established safe zones (Caputo and Smith).
• The average plating zone measured 94 degrees.

Conclusions:

• Positioning the plate anteriorly during pronation or posteriorly during supination offers a safe alternative for radial head fixation.
• This method effectively avoids proximal radioulnar joint impingement.
• All tested specimens achieved full range of motion, with plates located within standard safe zones.