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Sales rep reported on (b)(6) 2026 that the surgeon attached a 6-hole volar hook plate to the radius with a single 2.3 torx screw through the slot in the plate.Attention was then directed to the dorsal side of the radius, where a 6-hole dorsal hook plate was attached with a 2.3 torx screw.This screw was inserted until it protruded on the volar aspect of the radius and impacted the emplaced volar hook plate.This impaction forced the volar hook plate off the bone, acting as a lever around the head of the screw affixing it in place, and pushing it over and off the screw and detaching the distal hooks from bone.The volar hook plate required removal from the surgical site and could not be reinstalled or replaced due to the comminution of the bone around the insertion site and subsequent instability associated with the forced removal of the plate tines.The remaining volar screw was then prominent and required removal; this posed some difficulty for the surgeon as she struggled to get the screwdriver to seat into the head of the screw.The head of the screw may have been bent up while passing through the slot in the plate; the slot in the plate appears to have been widened at the point where the screw head passed through.As the site for placement of hook plate tines was no longer viable for fixation, the surgeon used a 42mm volar buttress pin with a 5-hole washer to achieve fixation on the volar surface of the distal radius.Fixation with the dorsal hook plate was not affected, and more screws were added to complete its attachment.Additionally, a 7-hole right radial peg plate was used to stabilize the radial styloid.Additional information was provided on 20feb2026 that this caused over a 30-minute delay in surgery due to the surgeon having to verify that another hook plate could not be reinstalled, they had to re-establish the reduction and install a volar buttress pin and wireform plate to complete the surgery.It was stated that this issue contributed to additional comminution of the distal radius where the hooks of the hook plate had been seated.
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