Jnl Wrist Surg 2017; 06(04): 340-348
DOI: 10.1055/s-0037-1603656
Wrist and Carpal Anatomy
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Detections of Screw Penetration during Volar Plating for Distal Radius Fractures

Soo Min Cha1, Hyun Dae Shin1
  • 1Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University, School of Medicine, Daejeon, Korea
Further Information

Publication History

14 December 2016

01 May 2017

Publication Date:
02 June 2017 (eFirst)

Abstract

Background We evaluated the detection for screw penetration on the dorsal cortex of the radius in serial oblique, dorsal tangential, and radial groove radiographic views in volar plating fixation.

Materials and Methods Eight screw positions were set in each of the four cadaveric radii. Screw 1 was placed in the styloid subregion, whereas screws 2 and 3 were placed just proximal to the styloid and were defined for the radial region of the radius. Screws 4 (distal to the extensor pollicis longus [EPL] groove), 5 (the distal half of the groove), and 6 (the proximal half of the groove) were placed in the central region of the radius. Screws 7 (just medial to the groove) and 8 (sigmoid notch subregion) were positioned in the ulnar region of the radius. The screws were overlengthened by 1 and 2 mm and were evaluated in three radiographic views.

Results Penetrations in the radial region were fully visible in supinated oblique views with 1- and 2-mm overlengthened screws. The penetration of screw 4 was clearly observable over a considerable range of views. However, the 1-mm penetration of screw 5 was not detectable at any angle of projection. Detection of the ulnar region screw was the most difficult among the three regions with oblique views. In the dorsal tangential view, the 1-mm penetration of screw 4 was not observed in any of the four radii, but the penetration of screw 5 was detectable in all the radii. The screws 2, 3, 5, 7, and 8 were readily detectable. The screw 4 was barely seen in the radial groove view, while the screws 5 and 6 were readily detectable.

Conclusion/Clinical Relevance Appropriate combinations of these well-known radiological views are essential for the overall detection of penetrated screws during plating in distal radius fractures.

Ethical Review Committee Statement

Our Institutional Review Board approved this study (IRB No. CNUH 2014–12–011).


Funding

None.


Supplementary Material