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dc.contributor.authorBergsma, Minke
dc.contributor.authorDoornberg, Job N
dc.contributor.authorDuit, Robin
dc.contributor.authorSaarig, Aimane
dc.contributor.authorWorsley, David
dc.contributor.authorJaarsma, Ruurd Lucas
dc.date.accessioned2018-10-11T00:45:34Z
dc.date.available2018-10-11T00:45:34Z
dc.date.issued2018-06-22
dc.identifier.citationBergsma, 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.issn1879-0267
dc.identifier.urihttp://hdl.handle.net/2328/38390
dc.descriptionThis 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 policyen_US
dc.description.abstractThe 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.sponsorshipNo funding was provided for this study.en_US
dc.language.isoenen_US
dc.publisherElsevieren_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.subjectVolar locking plateen_US
dc.subjectProtruding screwsen_US
dc.subjectOpen reduction and internal fixationen_US
dc.subjectDistal radius fractureen_US
dc.subjectDorsal tangential viewen_US
dc.titleVolar plating in distal radius fractures: A prospective clinical study on efficacy of dorsal tangential views to avoid screw penetrationen_US
dc.typeArticleen_US
dc.identifier.doihttps://doi.org/10.1016/j.injury.2018.06.023en_US
dc.rights.holder© 2018 Published by Elsevier Ltd.en_US
dc.rights.licenseCC-BY-NC-ND
local.contributor.authorOrcidLookupBergsma, Minke: https://orcid.org/0000-0001-5053-8261en_US
local.contributor.authorOrcidLookupJaarsma, Ruurd Lucas: https://orcid.org/0000-0003-4308-7815en_US


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