Fluoroscopic Evaluation of Intra-Articular Screw Placement During Locked Volar Plating of the Distal Radius: A Cadaveric Study

Soong, Maximillian; Got, Christopher; Katarincic, Julia A.; Akelman, Edward

doi:10.1016/j.jhsa.2008.07.021

Cited by 52 publications

(60 citation statements)

References 8 publications

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“…These problems may cause a greater impact on hand function than does the distal radius fracture. 276,277 A traction view can be helpful in determining the fracture pattern and stability. 278 …”

Section: Radiographic Evaluationmentioning

confidence: 99%

A Guide to Improving the Care of Patients with Fragility Fractures, Edition 2

Mears¹,

Kates²

2015

Geriatr Orthop Surg Rehabil

130

121

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Over the past 4 decades, much has been learned about the pathophysiology and treatment of osteoporosis, the prevention of fragility fractures, and the perioperative management of patients who have these debilitating injuries. However, the volume of published literature on this topic is staggering and far too voluminous for any clinician to review and synthesize by him or herself. This manuscript thoroughly summarizes the latest research on fragility fractures and provides the reader with valuable strategies to optimize the prevention and management of these devastating injuries. The information contained in this article will prove invaluable to any health care provider or health system administrator who is involved in the prevention and management of fragility hip fractures. As providers begin to gain a better understanding of the principles espoused in this article, it is our hope that they will be able to use this information to optimize the care they provide for elderly patients who are at risk of or who have osteoporotic fractures.

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Section: Radiographic Evaluationmentioning

confidence: 99%

A Guide to Improving the Care of Patients with Fragility Fractures, Edition 2

Mears¹,

Kates²

2015

Geriatr Orthop Surg Rehabil

130

121

View full text Add to dashboard Cite

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“…In a cadaver study by Soong et al, [20] tomography was not used for the evaluation of intra-articular screw placement, but examination was made using standard PA, 11° tilt PA, standard lateral and 15°, 23° and 30° lateral tilt fluoroscopic images. It was stated that low angle lateral images were more specific for ulnar screws and high angle images for radial screws.…”

Section: Discussionmentioning

confidence: 99%

Is it possible to avoid intra-articular screw penetration with minimal use of fluoroscopy in the application of distal radius volar plate?

Aldemir¹

2017

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada distal radius volar plak uygulamasında minimum floroskopi kullanılarak eklem içi vida penetrasyonundan kaçınmanın ve böylece cerrahi ekibin radyasyona maruz kalma riskinin minimuma indirilmesinin mümkün olup olmadığı araştırıldı. Hastalar ve yöntemler: Haziran 2014 -Mayıs 2016 tarihleri arasında instabil distal radius kırığı olan 50 hastada (22 erkek, 28 kadın; ort. yaş 43.52 yıl; dağılım 18-76 yıl) kırık redüksiyonunu takiben distal vida ile volar plak uygulaması minimum floroskopi kullanımı ile gerçekleştirildi. Özel tasarlanmış volar anatomik plak lunat fossanın fasetinin ucundan proksimale doğru 3 mm mesafe oluşturularak uygulandı. Bulgular: Vida yataklarına özel açı verilerek tasarlanmış plak ile tarif edilen cerrahi tekniğe dikkat ederek ve minimum düzeyde floroskopi kullanarak yaptığımız plakvida uygulamalarında eklem içi vida komplikasyonu ile karşılaşılmadı. Ameliyat sırasında floroskopi minimum düzeyde uygulandı ve eklem içi vida kullanımını düşündürecek herhangi bir bulguya rastlanmadı. Ameliyat sırasında ve sonrasında el bileği hareketlerinde kısıtlılık, takılma ya da sürtünme bulgularına rastlanmadı. Sonuç: Volar plak ve distal kilit vida yatağı tasarımındaki iyileştirmeler ile eklem içi vida komplikasyonları olasılığını ve erken dönem tekrar cerrahi düzeltme ihtiyacını ortadan kaldırmak ve cerrahi ekibin radyasyona maruz kalma riskini minimuma indirmek mümkündür.Anahtar sözcükler: Distal radius kırığı; floroskopi, volar anatomik plak. ABSTRACTObjectives: This study aims to investigate whether or not it is possible to avoid intra-articular screw penetration in the application of distal radius volar plate with minimal use of fluoroscopy and thereby reduce to a minimum the risk of exposure of the surgical team to radiation. Patients and methods: Volar plate with distal screw application with minimal use of fluoroscopy was performed in a total of 50 patients (22 males, 28 females; mean age 43.52 years; range 18 to 76 years) with unstable distal radius fracture following reduction of fracture between June 2014 and May 2016. A specially designed volar anatomic plate was applied by creating a 3 mm gap proximal from the tip of the facet of the lunate fossa. Results: No intra-articular screw complication was observed during plate-screw applications that we performed by using fluoroscopy at a minimum level and paying attention to the surgical technique described with the plate designed by giving a specific angle to screw beds. During the operation, fluoroscopy was performed at a minimum level and no finding was observed which could suggest use of intra-articular screw. No findings of restriction in wrist movements, locking or friction were observed intra-or postoperatively. Conclusion: With improvements in the design of the volar plate and the distal locking screw bed, it is possible to rule out the possibility of intra-articular screw complications and the need for surgical re-correction in the early-term, and to reduce to a minimum the risk of exposure of the surgical team to radiation.

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“…17 The accuracy of the radiographs in confirming screw position was determined by arthrotomy. They used a goniometer to tilt the forearm at the required angles (15°, 23°, 30° tilted laterals, and 11°t ilted PA).…”

Section: Discussionmentioning

confidence: 99%