Eulji University College of Medicine, 1306 Dunsan-dong, Seo-gu, Daejeon 302-799, South Korea.
Bone Joint J. 2013 Oct;95-B(10):1372-6. doi: 10.1302/0301-620X.95B10.31453.
The aims of this study were to assess the efficacy of a newly designed radiological technique (the radial groove view) for the detection of protrusion of screws in the groove for the extensor pollicis longus tendon (EPL) during plating of distal radial fractures. We also aimed to determine the optimum position of the forearm to obtain this view. We initially analysed the anatomy of the EPL groove by performing three-dimensional CT on 51 normal forearms. The mean horizontal angle of the groove was 17.8° (14° to 23°). We found that the ideal position of the fluoroscopic beam to obtain this view was 20° in the horizontal plane and 5° in the sagittal plane. We then intra-operatively assessed the use of the radial groove view for detecting protrusion of screws in the EPL groove in 93 fractures that were treated by volar plating. A total of 13 protruding screws were detected. They were changed to shorter screws and these patients underwent CT scans of the wrist immediately post-operatively. There remained one screw that was protruding. These findings suggest that the use of the radial groove view intra-operatively is a good method of assessing the possible protrusion of screws into the groove of EPL when plating a fracture of the distal radius.
本研究旨在评估一种新设计的放射影像学技术（桡骨沟视图）在桡骨远端骨折钢板固定术中检测伸拇长肌腱（EPL）肌腱槽中螺钉突出的效果。我们还旨在确定获得该视图的最佳前臂位置。我们首先通过对 51 个正常前臂进行三维 CT 分析 EPL 沟的解剖结构。槽的平均水平角度为 17.8°（14°至 23°）。我们发现获得该视图的理想透视光束位置为 20°在水平面上和 5°在矢状面上。然后，我们对 93 例采用掌侧钢板固定治疗的骨折术中使用桡骨沟视图检测 EPL 沟中螺钉突出的情况进行了评估。共发现 13 颗突出的螺钉。将其更换为较短的螺钉，这些患者术后立即进行腕关节 CT 扫描。仍有 1 颗螺钉突出。这些发现表明，在桡骨远端骨折钢板固定术中，术中使用桡骨沟视图是评估螺钉可能突出到 EPL 槽中的一种很好的方法。
