Product Overview

Acu-Loc 2 Wrist Plating System is a comprehensive solution for distal radius and distal ulna fracture management. It offers a wide array of plate families and screws to accommodate multiple surgical approaches to address simple to complex distal radius and marginal rim fractures and bridge plating fixation.

Trusted by over one million surgeons worldwide, Acu-Loc 2 is anatomically contoured with proprietary instrumentation for consistent plate placement and a robust, rigid construct.

Acu-Loc^®

Wrist Plating System

A LEGACY OF TRUST AND CLINICAL RELIABILITY FOR

20 YEARS

Managing Volar Lip Fragments: Overview using the Avulsion Hook Plate over the distal radius plate to aid in controlling volar escape of the carpus.

The optional Avulsion Hook Plate provides stability and fixation to challenging volar and dorsal marginal rim fragments. Its ultra-thin profile of 0.8 mm helps to minimize risk of soft-tissue complication for optimal comfort, and healing. Dr. Willaim Pientka, MD demonstrates the surgical technique to control volar fragments over the distal radius plate in ulnar and radial corners.

Managing Dorsal Lip Fragments: Overview Frag-Loc Compression Screw and the Avulsion Hook Plate to address dorsal fragments from a volar approach

The Acumed Avulsion Hook Plate stabilizes challenging volar and dorsal marginal rim fragments. Its ultra-thin 0.8 mm profile reduces soft tissue complications for improved comfort and healing. Dr. Niedermeier, MD demonstrates the surgical technique using the Frag-Loc Compression Screw to control dorsal comminution.

Acu-Loc 2 Volar Distal Radius Plate Surgical Technique Overview Animation

The standard Acu-Loc 2 Volar Distal Radius Plate is designed to closely replicate the anatomical contours of the distal radius and may assist in restoring the original geometry. In this animation, the surgical steps for installation of a standard volar distal radius plate are overviewed incorporating the 2.7 mm Low-Profile Hexalobe Screw.

Product Training Series: Acu-Loc 2 Wrist Plating System Key Features

The Acumed Acu-Loc 2 Plating System is a next-generation solution in plating fixation that focuses on complete implant options and a streamlined surgical process. Santana Galaviz, Senior Product Manager for the Hand and Wrist Portfolio, takes us through the system’s key features as highlighted in the Field Guide.

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Flexible Configurations

Acumed offers over 24 validated Acu-Loc 2 Wrist Plating configurations to best support diverse market needs.

The most comprehensive, full configuration is available along with our most streamlined essential configuration in our small-footprint Acu-Loc 2 CORE tray.

Additional options are available. Contact us to find out which configuration may be right for you.

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Key Publications

This collection of published literature represents clinical evidence, which along with innovation, education, and quality form Acumed’s foundations of excellence. In addition to citing existing scholarly papers, we conduct ongoing clinical research and use this information for validation and continuous improvement to deliver the greatest value to our customers.

The Effects of the Frag-Loc Compression Screw on Distal Radius Fracture With a Displaced Dorsoulnar Fragment

Publication Excerpt

“Dorsal plate fixation using a dorsal approach offers the advantages of direct visualization and reduction of the dorsoulnar fragment. However, hardware-related extensor tendon irritation, weak fixation power of the dorsal screw, and technical difficulties are major limitations of dorsal plate fixation [8–10]. Recently, the Frag-Loc compression screw (Acumed, Hillsboro, OR, USA) has become available. This screw system was designed to immobilize the dorsal bone fragment of distal radius fracture using a palmar locking plate. Herein, we evaluate the radiographic and clinical outcomes of surgery using Frag-Loc compression screw with palmar locking plate fixation for distal radius fractures that include a displaced dorsoulnar fragment.”

Journal Abstract

Purpose
The purpose of this study is to evaluate the radiographic and clinical outcomes of the Frag-Loc compression screw with palmar plate fixation on distal radius fractures that include a displaced dorsoulnar fragment.

Patients and Methods
This retrospective comparative study enrolled 48 patients who had an unstable distal radius fracture and a dorsoulnar fragment that was more than 2 mm displaced and that had involvement of more than one-quarter of the articular surface. Twenty-six of the 48 patients were treated with a palmar locking plate without a Frag-Loc compression screw (group 1) and the other 22 patients were treated with palmar locking plate with a Frag-Loc compression screw to fix the dorsoulnar fragment (group 2). First, we reviewed all pre-surgical computerized tomographic (CT) scans. Second, we used the gap distance between the dorsoulnar and palmar fragment as seen on post-surgical axial and sagittal CT scans to determine outcome. The gap distance was measured at the point of maximum distance perpendicular to the plane of the main fracture line. Clinical outcomes were evaluated based on the patient-rated wrist evaluation (PRWE) score; the disabilities of the arm, shoulder and hand score; wrist active range of motion; and grip strength.

Results
There were no statistically significant differences in clinical outcome between the two groups. However, there were statistically significant differences in post-surgical gap distance. The mean post-surgical gap distances for group 1 were 1.3 mm (range 0.2–3.8 mm) on axial CT scans and 1.4 mm (range 0.5–2.4 mm) on sagittal CT scans, while the mean post-surgical gap distances for group 2 were 0.7 mm (range 0.7–1.6 mm) and 0.7 mm (range 0.3–1.1 mm).

Conclusion
This study shows that the Frag-Loc compression screw can reduce the gap distance between the dorsoulnar fragment and the distal radius, according to evaluation of post-surgical axial and sagittal CT scans. This result suggests that the Frag-Loc compression screw is an effective and simple treatment option to immobilize a dorsoulnar fragment associated with distal radius fracture.

Reference

Lee J, Cho J, Lee S. The effects of the frag-loc compression screw on distal radius fracture with a displaced dorsoulnar fragment. Arch Orthop Trauma Surg. 2015;135(9):1315-1321.

Download Key Publications PDF

Case Studies

Distal Radius Fractures: Alternative Approach to Keystone Fragment Fixation

William Pientka, MD uses the Acumed Acu-Loc 2 Wrist Plating System to treat a 42-year-old male who presented to emergency room after a fall from ladder resulted in wrist pain and deformity. X-rays showed comminuted intraarticular displaced left distal radius... [Continue reading this case study]

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Features

Comprehensive Plating System
Standard, Variable Angle Locking, Fragment Specific and Extension Plates address a variety of fracture patterns.
Fracture Support
The distal screw row is designed for subchondral support, while the two styloid screws target the radial column. Suture holes on the ulnar corner of the plate and an optional hook plate facilitate fixation of volar rim fractures.
Frag-Loc^® Technology
Patented two-part cannulated compression screw is designed to compress dorsal fragments and integrates with the optional avulsion hook plate for a dorsal approach to marginal rim fracture fixation.
Instrumentation
Innovative instrumentation includes a targeting guide with radiopaque markings that allow visualization of anticipated screw trajectories. Kickstand posts are offered for distal first reduction and corrective osteotomy procedures.
Modular Extension Plate Attachments
Offer surgeons the option to extend any of the long and wide Volar Distal Radius Proximal Plates up to 176 mm.

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Distal Radius Fragment Specific (DRFS) Plates

Acumed Distal Radius Fragment Specific (DRFS) Plates are designed to independently address the fractures of the intermediate and radial columns. The modular nature of the plates, which include the Dorsal Rim Buttress Plate, Dorsal Lunate Plate, Volar Lunate Suture Plate, and Divergent Radial Styloid Plate, allows compression of fracture fragments from multiple directions.

The Divergent Radial Styloid Plate buttresses the radial column. Targeted distal screw placement is designed to provide subchondral bone support, with one screw targeting the dorsal rim of the sigmoid notch and the other targeting the volar rim. In addition, fixed-angle screw trajectories are designed to avoid the sigmoid fossa, minimizing penetration of the distal radioulnar joint.

The Dorsal Lunate Plate is designed to provide support to fracture patterns that involve the dorsal lunate facet of the distal radius and the sigmoid notch. The Dorsal Lunate Plate can be inserted through a smaller incision than a standard dorsal approach. For added stability, three plate screws are designed to target the subchondral bone and support the lunate facet.

The Dorsal Rim Buttress Plate, designed for distal radius fractures, is positioned on the dorsal ulnar side of the radius. The plate extends radially to support dorsal lip comminution and buttress dorsal fragments. Three screws are designed to target the subchondral bone and support the lunate facet, while a screw can be inserted ulnar-to-radial for further radial styloid support.

The Volar Lunate Suture Plate supports the volar ulnar corner of the distal radius. Built-in suture holes allow for sutures to be used with the plate to capture small articular fragments. Distal plate placement may maximize volar ulnar lip support, while three screws target the subchondral bone to support the lunate facet.

Standard Volar Distal Radius Plates

Acumed Acu-Loc 2 Standard Volar Distal Radius Plates have an optimized design to closely replicate the anatomical contours of the distal radius and assist in restoring its natural geometry.

Other optimized features include a lower profile, polished finish which may help minimize soft tissue irritation, and converging ulnar screws, additional suture holes, and added K-wire holes for provisional fixation.

Avulsion Hook Plate (Optional)

The Acumed Avulsion Hook Plate is designed to provide more stability than a K-wire when a fragment is too small for a single lag screw. When used with the Standard Volar Distal Radius Plate, the ultra-thin 0.8 mm Avulsion Hook Plate offers extended fixation and articular buttress for marginal rim fractures via either volar or dorsal surgical approaches.

Brochure: Acu-Loc 2 with the Avulsion Hook Plate Marginal Rim Fracture Fixation

White Paper: Controlling the Critical Corner – Daniel J. Brown

Case Study: Distal Radius Fractures: Alternative Approach to Keystone Fragment Fixation – William Pientka, MD

Managing Dorsal Lip Fragments: Overview Frag-Loc Compression Screw and the Avulsion Hook Plate to address dorsal fragments from a volar approach.

Managing Volar Lip Fragment: Overview under the distal radius plate

The optional Acumed Avulsion Hook Plate provides stability and fixation to challenging volar and dorsal marginal rim fragments. Its ultra-thin profile of 0.8 mm helps to minimize risk of soft-tissue complication for optimal comfort, and healing. Dr. Niedermeier, MD demonstrates the surgical technique to control volar fragments under the distal radius plate.

Managing Volar Lip Fragments: Overview using the Avulsion Hook Plate over the distal radius plate to aid in controlling volar escape of the carpus

The optional Acumed Avulsion Hook Plate provides stability and fixation to challenging volar and dorsal marginal rim fragments. Its ultra-thin profile of 0.8 mm helps to minimize risk of soft-tissue complication for optimal comfort, and healing. Dr. Willaim Pientka, MD demonstrates the surgical technique to control volar fragments over the distal radius plate in ulnar and radial corners.

Proximal Volar Distal Radius (VDR) Plates

The Acumed Acu-Loc 2 Proximal Volar Distal Radius (VDR) Plates are designed for distal radius fracture and osteotomies, as well as segmented diaphyseal fractures. Customizable plate length and width options allow for sizing of varying patient anatomies.

In addition, converging ulnar screws, suture holes, and K-wire holes have been incorporated to support the volar ulnar lip and lunate facet. The 2.3 mm Variable Angle screws can also be used with this plate family.

Extension Plates

Acumed Acu-Loc 2 Extension Plates are designed to lock to Acu-Loc 2 Proximal VDR Plates to provide rigid fixation of segmental fractures of the distal radius that extend into the diaphyseal region. The proximal plate end is tapered and the undersurface is designed for limited contact with the bone.

Frag-Loc Compression Screw

The Frag-Loc Compression Screw is a two-part cannulated compression screw for dorsal comminution that gives surgeons the option for steadfast dorsal compression through a small dorsal incision. In addition, the undersurface geometry of the screw head allows for sub-osseous purchase into the dorsal fragment while designed for minimizing hardware prominence.

Variable Angle Locking Screws

Acumed Variable Angle Locking Screws can aid in the capture of specific fragments or accommodate variations in patient anatomy. They can be used in any distal hole of any of the gold colored Acu-Loc 2 Proximal VDR Plates or Acu-Loc Extra Articular Plates. The screws allow for a total variance of 5 mm or 15 degrees.

2.7 mm Low-Profile Hexalobe Screws

Single Drill for Surgical Efficiency: When plating the distal radius and ulna, the 2.7 mm Low-Profile Hexalobe Screw and the 2.3 mm screws that are used for fixation both use the 2.0 mm Quick-Release Drill.

Reduced insertion torque for easier advancement: 2.7 mm Low-Profile Hexalobe Screws have a 58.5% reduction in insertion torque compared to 2.7 mm Hexalobe Screws.*

Tailored to your patient’s needs: A smaller diameter screw is designed to address fractures in smaller bones or smaller-stature patients.

*Data on file with Acumed.