Displaced or unstable distal radius fractures are often treated with a volar locking plate to stabilise the fracture and allow early mobilisation. Recent legislative changes around Medical Device Regulation (MDR), along with concerns around infection and corrosion, have led to a push towards individually sterile-packed implants. Surgeons are concerned that this approach will increase operative time and require more complex stock management than having sterile screws available on a caddy. This retrospective cohort study included all patients who underwent an isolated acute distal radius fracture fixation under regional block in a Day Surgery Unit, using the Stryker Variax Xpress system. Usability was assessed by looking at tourniquet time and storage space requirements. 390 isolated distal radius fractures were fixed with the Xpress system. The average tourniquet time was 46 minutes, significantly lower than the 70 minutes observed with systems with individually packed screws (p<0.00001) and lower than the 68.8 minute average reported in the literature. Five distal radius fixations were completed routinely on one theatre list. This system requires 80% less storage space than conventional sterile-packed system and is portable for use in peripheral hospitals. It was used for 96% of all distal radius fracture fixations, with alternative systems mainly reserved for dorsal plating. The plate-in-a-box system significantly reduces tourniquet time and offers a portable, efficient solution well-suited for tertiary and peripheral hospitals. The development of a dorsal plate-in-a-box system extends this benefit to dorsal plating procedures.
Jones et al. (Tue,) studied this question.
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