Oc Yunus, Kilinc Bekir Eray, Gulcu Anıl, Varol Ali, Ertugrul Rodi, Kara Adnan
Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Cad., Etfal Sk, Şişli, 34371, Istanbul, Turkey.
Golhisar State Hospital, Fatih Mahallesi, Cumhuriyet Cad, 15400, Gölhisar, Burdur, Turkey.
J Orthop Surg Res. 2018 Apr 3;13(1):70. doi: 10.1186/s13018-018-0774-5.
Complications related to extensor tendons have begun to increase with the use of volar plates in the treatment of distal radius fractures. In this study, we aimed to compare four-plane radiography and ultrasonography in the evaluation of dorsal cortex screw penetration following volar plate fixation.
We recruited 47 patients (33 males, 14 females, mean age 37.4 years; range 18-58 years). To evaluate dorsal screw penetration in all patients, we performed radiographs at 45° pronation, 45° supination and obtained dorsal tangential graphs at maximum palmar flexion, and a wrist lateral radiograph. Wrist ultrasonography was performed in all patients.
Dorsal screw penetration was detected in 12 of the 47 patients undergoing VLP application. While there was > 2 mm screw penetration in seven patients, there was < 2 mm screw penetration in five patients. On four-plane radiographs, screw penetration > 2 mm was detected in seven patients and screw penetration < 2 mm was detected in two patients. On four-plane radiography, dorsal screw penetration was not detected in three out of five patients, who were shown to have < 2 mm screw penetration by ultrasonography. In addition to perioperative four-plane radiographs are also required to detect dorsal cortex penetration in patients undergoing VLP due to distal radius fracture. However, the detection of screw penetrations < 2 mm is more likely with ultrasonography compared to four-plane radiography.
We recommend that dorsal cortex screw penetration should be evaluated with perioperative ultrasonography.
Research Registry, researchregistry3344 , Registered 10 January 2017.
随着掌侧板用于治疗桡骨远端骨折，与伸肌腱相关的并发症开始增多。在本研究中，我们旨在比较四平面X线摄影和超声检查在评估掌侧板固定后背侧皮质螺钉穿透情况中的作用。
我们招募了47例患者（男性33例，女性14例，平均年龄37.4岁；范围18 - 58岁）。为评估所有患者的背侧螺钉穿透情况，我们在旋前45°、旋后45°时进行X线摄影，并在最大掌屈时获得背侧切线位图像以及腕关节侧位X线片。对所有患者进行腕关节超声检查。
在47例行掌侧板固定的患者中，有12例检测到背侧螺钉穿透。7例患者的螺钉穿透>2mm，5例患者的螺钉穿透<2mm。在四平面X线片上，7例患者检测到螺钉穿透>2mm，2例患者检测到螺钉穿透<2mm。在四平面X线摄影中，5例患者中有3例未检测到背侧螺钉穿透，而超声检查显示这3例患者的螺钉穿透<2mm。除了围手术期四平面X线片外，桡骨远端骨折行掌侧板固定的患者检测背侧皮质穿透还需要超声检查。然而，与四平面X线摄影相比，超声检查更有可能检测到<2mm的螺钉穿透。
我们建议采用围手术期超声检查来评估背侧皮质螺钉穿透情况。
Research Registry，researchregistry3344，2017年1月10日注册。
