Distal Radius & Ulna Fracture Fixation
The T-Pin® for Distal Radius & Distal Ulna Fracture Fixation
Reliable Smart Fixation
The T-Pin® is a novel instrument designed to stabilize extraarticular distal radius fractures utilizing minimal surgical dissection.
Allows for Early Range of Motion
The T-Pin® allows for early active wrist range of motion promoting earlier return to functional activities.
- The T-Pin® (Click to Expand/Collapse)
- Historical Perspective
- Surgical Technique
The T-Pin® is a threaded, cannulated pin designed to stabilize distal radius and distal ulna fractures. Advantages of the threaded pin include:
- Smaller surgical exposure than other implants
- Strength to tolerate early postoperative active wrist motion
- Relative economy of the device
Fractures of the distal radius are one of the most common fractures treated by orthopaedic surgeons. Various procedures and fixation techniques have evolved to treat this common fracture based on many considerations, including:
- Patient's age
- Bone quality
- Ability of the patient to tolerate the procedure
- Type of fracture
Treatment modalities have included:
- Immobilization as originally described by Colles
- Pins in plaster
- External fixation
- Percutaneous pinning with casting
- Open reduction with internal fixation with a number of different implants
Since Abraham Colles described the comminuted and displaced distal radius fracture in 1814, orthopaedic surgeons have sought to stabilize the fracture after reduction. Many fractures treated in plaster have a tendency to redisplace. For this reason, percutaneous pinning evolved as a relatively simple fixation method for extraarticular fractures prone to redisplacement with cast treatment alone. Various methods of pinning have been developed.
Despite improved maintenance of reduction with pinning, many of these series report 25% to 33% of patients having a significant loss of reduction. The T-Pin® is a new type of threaded pin designed specifically to treat acute distal radius fractures. The T-Pin® technique has the following advantages:
- Short operative time
- Relatively inexpensive
- Having utility for patients with medical conditions for whom general anesthesia poses a greater risk
- Allowing early active wrist motion
The T-Pin®'s threaded design likely affords better purchase of the fracture fragments than commonly used smooth pins.
Case Amenable to T-Pin® Fixation
The main indications for use of the T-Pin®:
- An unstable extraarticular dorsally displaced distal radius fracture
- Radial styloid fracture
- Unstable ulna neck fractures that have commonly been treated with plating have the disadvantage that the hardware can be symptomatic after healing and requires removal. The low-profile T-Pin® eliminates hardware problems.
The contraindications to T-Pin® fixation include:
- Intraarticular fractures having displacement and/or severe comminution
- Low-demand patients who have fractures amenable to treatment by immobilization alone
Generally, T-Pins® do not require removal and are left in place. Some patients; however, desire removal. Pins are removed with a removal tool designed to fit the flutes in the distal threads of the T-Pin®, which is included in the pinning tray.
A 4.0 mm hollow mill is useful for cleaning scar tissue or bone from the distal threads of the T-Pin® to allow easy placement of the removal tool.
Once full fracture healing has occurred after the pin has been removed as assessed by no tenderness from palpation at the fracture site an unrestricted program of range of motion and strengthening can begin. The protective splint is discontinued at this time.