Volar plating in distal radius fractures: A prospective clinical study on efficacy of dorsal tangential views to avoid screw penetration

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dc.contributor.author Bergsma, Minke
dc.contributor.author Doornberg, Job N
dc.contributor.author Duit, Robin
dc.contributor.author Saarig, Aimane
dc.contributor.author Worsley, David
dc.contributor.author Jaarsma, Ruurd Lucas
dc.date.accessioned 2018-10-11T00:45:34Z
dc.date.available 2018-10-11T00:45:34Z
dc.date.issued 2018-06-22
dc.description This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This author accepted manuscript is made available following 12 month embargo from date of publication (June 2018) in accordance with the publisher’s archiving policy en_US
dc.description.abstract The purpose of this prospective cohort study of patients treated with volar plating for distal radius fractures is to evaluate the efficacy (defined as detection rate, or the ability to detect dorsally protruding screws) of additional dorsal tangential views (DTV) after obtaining standard anteroposterior (AP) and elevated lateral views by evaluating the change in intraoperative strategy in 100 patients. Materials and methods 100 patients aged 18 years and older undergoing volar plating for acute extra- or intra- articular distal radius fractures were prospectively enrolled. Intraoperative fluoroscopy views, including AP, elevated lateral and DTV were obtained. Intraoperative –screw– revision frequency for dorsal screw protrusion, screw position relative to volar plate and to dorsal compartment, and screw lengths were evaluated. Results Additional DTV led to a change of intraoperative management in 31 of 100 (31%) of patients. A total of 35 out of 504 screws (6.9%) were changed. Screws in the two most radial screws in the plate were at the highest risk of being revised; 16 (46%) screws in most radial position and nine (26%) screws in the 2nd from radial position were revised. Furthermore, five (14%) screws in both the 2nd from ulnar and most ulnar screw holes were revised after DTV. No screws were revised in the central hole. The median length of revised protruding screws was 22 mm (range, 12–26 mm), and these were changed to a mean length of 20  mm (range, 10–22 mm). Conclusion In this prospective series of 100 patients, obtaining additional DTV is found to be efficacious as it led to change in intraoperative strategy in one-third of patients. We concur with previous pilot studies that DTV, after obtaining conventional AP and elevated lateral views, is advised to avoid dorsally protruding screws, which could minimise the potential for iatrogenic extensor tendon rupture after volar plating for distal radius fractures. Diagnostic accuracy of DTV is subject of a subsequent prospective cohort study with post-operative CT to serve as the reference standard. en_US
dc.description.sponsorship No funding was provided for this study. en_US
dc.identifier.citation Bergsma, M., Doornberg, J. N., Duit, R., Saarig, A., Worsley, D., & Jaarsma, R. (2018). Volar plating in distal radius fractures: A prospective clinical study on efficacy of dorsal tangential views to avoid screw penetration. Injury, 49(10): 1810-1815. en_US
dc.identifier.doi https://doi.org/10.1016/j.injury.2018.06.023 en_US
dc.identifier.issn 1879-0267
dc.identifier.uri http://hdl.handle.net/2328/38390
dc.language.iso en en_US
dc.publisher Elsevier en_US
dc.rights © 2018 Published by Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ en_US
dc.rights.holder © 2018 Published by Elsevier Ltd. en_US
dc.rights.license CC-BY-NC-ND
dc.subject Volar locking plate en_US
dc.subject Protruding screws en_US
dc.subject Open reduction and internal fixation en_US
dc.subject Distal radius fracture en_US
dc.subject Dorsal tangential view en_US
dc.title Volar plating in distal radius fractures: A prospective clinical study on efficacy of dorsal tangential views to avoid screw penetration en_US
dc.type Article en_US
local.contributor.authorOrcidLookup Bergsma, Minke: https://orcid.org/0000-0001-5053-8261 en_US
local.contributor.authorOrcidLookup Jaarsma, Ruurd Lucas: https://orcid.org/0000-0003-4308-7815 en_US
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