DVR Anatomic Plate Surgeon Testimonials - Biomet

DVR ® Anatomic Plate 

A 10 year landmark 

in clinical evidence 

Surgeon Testimonials 

DVR Testimonial Brochure.PRINT.indd 1 10/5/10 10:42:30

JEROEN VAN HAECKE 

AZ Groeninge, Kortrijk, Belgium 

When I started in orthopaedics, the treatment of wrist fractures was limited with nothing 

more than k-wires and cast, and I believed that all wrist fractures eventually healed well. As 

I evolved in my training and developed a serious interest for hand surgery, wrist fractures 

became one of my favourite topics. 

Number of DVR ® Anatomic Plate cases 

180 

DVR user since 

2005 

Main benefits 

Ease of use, quick surgery 

Favourite features 

Fixed angle k-wire holes 

I saw that sometimes the more serious wrist fractures treated with a plate, screws and 

sometimes bone grafts were recovering better than the simple fractures treated with 

k-wires and cast. Also the mobility of the patient was better due to the better reduction 

and direct mobilisation. 

I experienced this same effect in every joint treated with a plate. This is when I started to 

look for a good plating system specifically designed for the wrist. 

Influenced by reading an article written by Orbay and Fernández reporting promising 

results with the DVR ® Anatomic Plate, I started to use the system in 2005 and since then 

I’ve placed over 180 DVR ® Anatomic Plates. 

Palmar plating for wrist fractures has changed the total treatment plan. It started with an 

indication setting for open reduction and internal fixation and it now includes osteoporotic 

patients instead of just the high energy fractures. 

The operative plan has also changed; we now use the palmar approach making an incision 

over the course of the flexor carpi radialis and preserving the pronator quadrates. Holding 

the reduction is a great deal easier than before, allowing me to concentrate more on the 

fracture than on the fixation. By doing this my reduction becomes more anatomical. 

Subchondral support pegs used in osteoporotic patients made wrist fracture treatment in 

these patients easier, and now my results are better. 

Early mobilisation allows my elderly patients to start postoperative rehabilitation earlier and 

a faster return to normal activity allows them to remain independent. 

The DVR ® Anatomic Plate has a great design, is simple to use and very effective. The plate 

is a great help in reduction and a strong fixation tool. The surgeon still must have the 

knowledge to use it, therefore education remains important. 

1 


ANDREW BARROW 

Sunninghill Hospital, Johannesburg, South Africa 

Since the DVR ® Anatomic Plate first became available in South Africa in 2003, I have had 

the pleasure and privilege of being able to treat in excess of 300 patients with this ground 

breaking device. 

In my opinion George Orbay should be commended for being the first person to appreciate 

the true shape of the volar distal radius in terms of surface area and fixation using a locked 

plate. The DVR ® Anatomic Plate was truly ground-breaking in my management of distal 

radius fractures and since the inception of its use, I have now become more and more 

confident in strongly advocating volar radial fixation for almost all distal radial fractures. 

I think the DVR ® Anatomic Plate by virtue of its shape is the most anatomically suited plate 

on the market for restitution of normal anatomy. 

The DVR ® Anatomic Plate instrumentation, distal screws and overall user-friendliness of the 

entire system, make this radial plate a pleasure to use. The DVR ® Anatomic Plate enables 

patients to restore movement, rapidly regain function and return to normal ADL’s and work 

far sooner than any previous method used for treating distal radius fractures. 

It is with absolutely no bias, and no financial interest, that I can whole heartedly endorse a 

fantastic plating system. In my practice the DVR ® Anatomic Plate certainly has changed the 

life positively of many, many patients. 


Over 300 


2003 

Main benefits 

Ease of use, user friendly 


Anatomical design 

2 


MICHELE RAMPOLDI 

CTO Hospital, Rome, Italy 

I began to use the DVR ® Anatomic Plate system in 2006. 


120 


2006 

Main benefits 

Ease of use 

For me, one of the main features of the DVR ® Anatomic Plate is the anatomical shape 

and the thin distal end contour that fits onto the watershed line. The orientation of the 

fixed angle distal screws and the different plate size options is another great benefit of the 

DVR ® Anatomic Plate. There is a variety of plate lengths and widths providing flexibility 

depending on the anatomy of my patient. 

I find the DVR ® Anatomic Plate easy to apply on the radial surface. It allows me to 

achieve good anatomical restoration and subchondral support due to the double row of 

distal screws. 

The k-wire holes allow a temporary fixation of the plate to predict the exact positioning of 

the pegs and the F.A.S.T. Guide inserts allow for an easy drilling of the distal screws. 

With the DVR ® Anatomic Plate my patients get stability, minimal interference with 

surrounding soft tissues and early functional recovery. 


Anatomical shape, k-wires and F.A.S.T. Guide inserts 

3 


DIEGO FERNÁNDEZ 

Lindenhofspital, Bern, Switzerland 

I started to use the DVR ® Anatomic Plate when I received the first prototypes from 

Dr. Orbay, between 1998 and 1999. 

The DVR ® Anatomic Plate allows provisional fixation of the implant with the use of 

k-wires thus permitting optimal plate positioning. F.A.S.T. Guide inserts allow for an 

easy drilling of the fixed angle pegs without the need of attaching a drill guide manually 

for each hole, which could be time consuming. 

I really like the spatial fan shaped distribution of the pegs which follow the anatomy of the 

subchondral plate, providing the ideal buttress for osteoporotic bone and intra-articular 

fragments. If the plate is perfectly positioned restoration of normal distal radius anatomy is 

easy to achieve. 

I keep using the DVR ® Anatomic Plate because of the easiness of handling, design and 

instrumentation. 

The DVR ® Anatomic Plate enables patients to have a cast free after treatment, early 

motion and return to work (2-3 weeks for light manual activities, 6-8 weeks for high wrist 

demand). I think it is an ideal method of treatment for independent elderly individuals with 

osteoporosis. 


Over 120 


1998 

Main benefits 

Ease of use 


K-wires, F.A.S.T. Guide inserts, subchondral support 

4 


MIGUEL TRIGUEIROS 

Hospital Geral de Santo António, Portugal 

My first contact with the DVR ® Anatomic Plate was through a scientific paper in 2002, 

written by Jorge Orbay. At that time, the plate was presented as the solution for all 

problems related to distal radius fractures, such as reductions with unstable fixations, 

long period of immobilisation, high rates of infection, especially when using conservative 

treatments with k- wires, reflex sympathetic dystrophy syndromes. 


Over 200 


2005 

Main benefits 

Immediate mobilisation, simple procedure 


Anatomic design 

For the first time in 2004, I was able to use the volar approach in the treatment of distal 

radius fractures, with an anatomic plate and locking screws. 

My first case with the DVR ® Anatomic Plate was a 60 year old woman, active, mother of a 

fellow surgeon, with a type III (Fernandez/Júpiter) fracture. She had been previously treated 

with k-wires but with poor outcome. The plate was implanted three weeks after the initial 

trauma and the outcome was no post-op immobilisation, high degree of function and 

mobility at the four week post-op. 

This experience was the turning point for me as it finally confirmed the perceptions that I 

had since 2002. The standard treatment for unstable distal radius fractures should be with 

a plate implanted through a volar approach. Since then I have been treating an average of 

6 cases per month. 

My approach to distal radius fractures can be summed up in two clear points; First, classify 

the fracture according to the Fernandez/Jupiter classification. Second, verify the fracture 

stability: a) If stable – cast for 5 weeks; b) If unstable – OOS plating via volar approach 

The volar approach allows manipulation and fragment stabilisation, not only by the locking 

screws but also through the plate’s anatomical design. The plate’s contour also avoids 

flexors tendons interference. 

The stability achieved allows immediate mobilisation, with function and mobility recovery 

within an average of three weeks. 

The complication rate is very low; with the most common complication due to 

intra-articular screw placement, typically due to lack of experience from the surgeon. This 

technique is fairly simple, with a short learning curve, and should be considered as a must 

do for basic training for registrars (or junior Orthopaedic surgeons). 

The DVR ® Anatomic Plate has provided a big change in the treatment of articular and non 

articular distal radius fractures, and has decreased substantially the morbidity rate, social 

costs and other cost related to sickness leaves periods. 

From the patient point of view what was previously considered as a dramatic and 

incapacitating occurrence, is now understood as a problem with an “easy” solution. 

5 


MIGUEL DEL CERRO 

Hospital Gregorio Marañón, Madrid, Spain 

I have surgically treated over 500 cases of distal radius fractures. Early treatment consisted 

of using external fixators, k-wires and conventional plating systems. Four years ago I started 

to use the DVR ® Anatomic Plate and to date I have implanted over 200 DVR ® Anatomic 

Plates for treating distal radius fractures and osteotomies. 

The main benefit of this fixed angle implant combined with a divergent distal fixation 

pattern is that it allows for an early mobilisation of the wrist. Other available systems 

require a longer immobilisation period which causes mobility limitations and a longer 

postoperative rehabilitation. Very rarely have we achieved a normal mobilisation of a distal 

radius fracture treated with conventional systems. With the DVR ® Anatomic Plate the 

number of patients that have achieved a complete range of motion is highly significant. 

The learning curve with the DVR ® Anatomic Plate is a great deal shorter because the 

anatomical shape of the plate acts as a template when reducing the fracture. Once the 

fracture is reduced, the stability is given by the different divergent locking pegs and screws. 

These screws are placed easily with the use of the F.A.S.T. Guide inserts and once the 

distal screws are put in place the fixation given is very stable and secure. 

I believe Orbay’s anatomical studies on the surgical approach and reduction with a 

tenotomy of the brachioradialis have facilitated even more this procedure. 

The DVR ® Anatomic Plate allows an easy restoration of the distal radius anatomy. Without 

doubt, the surgeon should bring his experience in treating this type of fractures through 

adequate surgical manoeuvres. The plate helps but it is very important the surgeons have 

the know-how. 


Over 200 


2006 

Main benefits 

Ease of use 


Subchondral support pegs 

6 


THOR HALSE 

Capio St Görans Hospital, Stockholm, Sweden 

I have been using the DVR ® Anatomic Plate since it was introduced to Capio St Görans 

Hospital, Stockholm in 2007. We were the first hospital in a Nordic country to receive the 

distal radius system. 


100 


2007 

Main benefits 

Ease of use, quick surgery 


K-wires and F.A.S.T. Guide inserts 

The shape of the DVR ® Anatomic Plate and cradle of the three-dimensional pegs form helps 

me to recreate the anatomy from a volar approach. It works well for the most distal as well 

as severely comminuted fractures. 

For me, the main benefits of the DVR ® Anatomic Plate are the ease of use and the ability 

to perform quick surgery. The possibility to fixate the DVR ® Anatomic Plate temporarily 

to radius by using k-wires makes it easier to optimise the position of the plate to achieve 

anatomic reduction of the fracture. Once the k-wires are in place the procedure is really 

fast and the pegs and screws are easy to implant. Finally, the F.A.S.T. Guide inserts 

enhance my visualisation of the screw trajectories, thus making the it really easy and fast to 

do the drilling and measuring. 

The key to the procedure for me is the predefined screw trajectories that help me build 

a strong subchondral support to restore the natural anatomy. The different widths of the 

plate also give me the flexibility to recreate and maintain the natural anatomy. For example, 

using a wider DVR ® Anatomic Plate to obtain a stabilisation under the critical lunate fossa 

in a die-punch fracture as well as getting a good stabilisation of the radial styloid. 

Both my colleagues and I agree there have been great improvements in our patient’s 

outcome with the ability to quickly return to a normal life after a severe distal radius 

fracture compared to when we did not use the DVR ® Anatomic Plate. 

7 


NIKOLAI SPRANGER 

Unfallkrankenhaus Berlin, Germany 

I started to use the DVR ® Anatomic Plate in 2006. 

What I like most of the DVR ® Anatomic Plate is that it is simple and easy to use. With the 

DVR ® Anatomic Plate you may treat almost every fracture of the distal forearm. The DVR ® 

Anatomic Plate helps reduce the OR time and the X-Ray exposure. 

The DVR ® Anatomic Plate has an anatomic design that matches the watershed line. It is a 

simple, self-explanatory system which avoids screw-displacement. 

I think the DVR ® Anatomic Plate is a reliable and stable implant that helps the surgeon 

achieve excellent results for the treatment of distal radius fractures and reduces possible 

complications for the patient in further treatment. 


Over 50 


2006 

Main benefits 

Ease of use 



8 


AMAL KHOURY 

Hadassah Medical Center, Jerusalem, Israel 

Five years of experience and above 400 satisfied patients reassure my trust in the DVR ® 

Anatomic Plate almost on a daily basis. With its minimum number of tools and plates, and 

various fixation options the DVR ® Anatomic Plate wins both the simplicity and the variability 

games at once. 


Over 400 

The DVR ® Anatomic Plate’s asymmetric anatomic design allows me to get as close as 

possible to the natural anatomic structure of the joint, with maximum support and minimal 

chances for soft tissue irritation. In terms of fracture reduction, fixation, motion restoration 

and rehabilitation time, the DVR ® Anatomic Plate is an excellent choice. 


2005 

Main benefits 

Simplicity 



9 


JAMES WARNER 

Royal Bolton Hospital, Bolton, UK 

I began to use the DVR ® Anatomic Plate in February 2005 when it was first launched 

by Hand Innovations in the UK. I had followed Dr Orbay’s work in the literature and 

was keen to start using the plate as soon as it became available in the UK. I now have 

personal experience of approximately 250 DVR ® Anatomic Plate cases. In our hospital 

we fix approximately 250 wrists per year with this plate and have been very pleased with 

our outcomes. 

I feel that the DVR ® Anatomic Plate is very well designed and relatively simple to use. The 

plates fit the shape of the distal radius well, allowing the fracture to be moulded to the 

plate - using it as a template. The fact that the plate is designed to sit up to the watershed 

line means that the volar marginal fragment is usually nicely supported and yet the plate 

remains within the concavity of the volar aspect of the distal radius. Hence flexor tendon 

irritation should not be a problem with a well positioned implant. 

The k-wire holes in the proximal row not only provide a temporary hold of the fracture 

position, but also allow accurate positioning of the plate to ensure correct distal peg/ 

screw placement. The risk of inadvertent placement of a distal peg into the joint is 

therefore minimized. At the same time the surgeon can be confident that the fixed 

angle of the distal pegs/screws will ensure good support of the subchondral bone in the 

distal fragment. 

The F.A.S.T. Guide inserts are simple to use and don’t obscure the view of the distal 

fragments. It is therefore possible to manipulate the radial styloid fragment after fixation of 

the lunate fossa fragments in more complex displaced intra-articular fractures. 


Over 250 


2005 

Main benefits 

Immediate mobilisation 


Anatomic design, k-wires, FAST guides 

We have not needed to immobilise the wrist post surgery allowing earlier restoration 

of function and return to activities of daily living. Our patients have found this a 

definite benefit. 

Along with use of the extended FCR approach (as described by Dr Orbay), I have found that 

this plating system allows me to treat all but a very few acute fractures and malunions of 

the distal radius from the volar aspect and in a reproducible way. We have been able to 

achieve consistently good results at our hospital using the DVR ® Anatomic Plate in the 

management of both intra-articular and extra-articular fractures of the distal radius. 

10 


This publication is not intended for distribution in the USA. 

Never Stop Moving is a trademark of DePuy International Limited. 

DVR ® Anatomic Plate is a registered trademark and F.A.S.T. Guide is a trademark of DePuy Orthopaedics, Inc. 

© 2010 DePuy International Limited. All rights reserved. 

Registered in England No. 3319712 

Cat No: 0612-21-000 version 1 

DePuy International Ltd 

St Anthony’s Road 

Leeds LS11 8DT 

England 

Tel: +44 (0)113 387 7800 

Fax: +44 (0)113 387 7890 

0086 

Issued: 05/10

DVR Anatomic Plate Surgeon Testimonials - Biomet

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