Product Overview

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.

This comprehensive system includes several plate families to give surgeons the freedom to choose between distal or proximal sitting plates, three different plate extension options and fragment specific plating options.

The system also includes instrumentation for plate placement and fracture management.

Acu-Loc 2 Wrist Plating System with 2.7 mm Low-Profile Hexalobe Screws Overview

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. The addition of 2.7 mm Low-Profile screws provides more options for proximal shaft screws to accommodate varying patient anatomy.

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

The Volar Distal Ulna Plate was designed for fractures involving the ulnar head, ulnar neck, and fractures of the distal ulna. Usually, these injuries are associated with fractures of the distal radius. In this animation, the surgical steps for installation of a volar distal ulna plate are overviewed incorporating the 2.7 mm Low-Profile Hexalobe Screw.

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.

Contact your nearest Acumed sales rep for more information

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 Malunion Treated With Plating and Osteotomy

Nathan Edwin Lesley, MD uses the Acumed Acu-Loc 2 Wrist Plating System to treat a 63-year-old female who presented with a chronic malunion of the distal radius from a fracture treated nonoperatively five years earlier. A distal ulna excision had previously been performed for ulnocarpal impaction...

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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. The ulnar corner of the plate offers suture holes for addressing small volar fragments.
Frag Loc^® Technology
A patented, two-part cannulated compression screw is designed to compress dorsal fragments.
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.

360° Rotation

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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.

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.

Image Gallery

$Acu-Loc 2 Wrist Plating System : Lateral view of scaphoid fracture and radius fracture, using Acutrak 2 Mini and Acu-Loc DRFS Volar Suture lunate plate with FragLoc$

$Acu-Loc 2 Wrist Plating System : Lateral view of scaphoid fracture and radius fracture, using Acutrak 2 Mini and Acu-Loc 2 DRFS Volar Suture lunate plate with FragLoc$

$Acu-Loc 2 Wrist Plating System : Dorsal PA view, distal radius fracture, Acu-Loc 2 DRFS radial styloid plate and dorsal lunate plate$

$Acu-Loc 2 Wrist Plating System : Dorsal, oblique, lateral views - distal radius fracture, Acu-Loc 2 DRFS radial styloid plate and dorsal lunate plate$