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 Pinning
The fracture must be adequately reduced and pinned prior to nail insertion.
Step 2: Perform Exposure and Enter Canal
Protect the branches of the superficial radial sensory nerve at all times.
Step 3: Insert Nail and Distal Locking Screws
Insert 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 Close
Confirm 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.
We reported a prospective analysis of patients treated for an unstable distal radial fracture with an intramedullary nail.
What to Watch For
Pitfalls & Challenges