El Amiri Laëla, Igeta Yuka, Pizza Chiara, Facca Sybille, Hidalgo Diaz Juan José, Philippe Liverneaux
Department of Hand Surgery, SOS Main, CCOM, University Hospital of Strasbourg, FMTS, Icube CNRS 7357, University of Strasbourg, 10 Avenue Baumann, 67400, Illkirch, France.
Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.
Eur J Orthop Surg Traumatol. 2019 Apr;29(3):583-590. doi: 10.1007/s00590-018-2335-3. Epub 2018 Oct 29.
The aim of our study was to compare the vertical fluoroscopic view of the wrist in extension and supination (ES) to the view in flexion and supination (FS) and determine which of the two views allowed the best visualization of four selected anatomical landmarks SDLR (radial styloid, dorsal radius cortex, Lister's tubercle and distal radioulnar joint). Our case series included 50 patients who had suffered a distal radius fracture and undergone an open reduction and internal fixation procedure with a volar locking plate. For each case, two fluoroscopic views were taken: ES (wrist extension and supination) (group I) and FS (wrist flexion and supination) (group II). Ten observers had to recognize the SDLR anatomical landmarks on 100 fluoroscopic skyline views (time 1) and 15 days later (time 2). The rate of recognition of the four anatomical landmarks was 78% in group I and 66% in group II (p < 0.001). The concordance rate of recognition of the four anatomical landmarks was mediocre (κ = 0.411). In conclusion, the vertical fluoroscopic skyline view in wrist extension and supination seems to be the most adequate view to assess the quality of the fracture reduction, the distal radioulnar joint and the length of the screws in open reduction and internal fixation of distal radius fractures with volar locking plates.
我们研究的目的是比较腕关节伸展和旋后位（ES）的垂直透视视图与屈曲和旋后位（FS）的视图，并确定这两种视图中哪一种能最佳显示四个选定的解剖标志SDLR（桡骨茎突、桡骨背侧皮质、李斯特结节和桡尺远侧关节）。我们的病例系列包括50例桡骨远端骨折患者，他们接受了掌侧锁定钢板切开复位内固定手术。对于每个病例，拍摄了两个透视视图：ES（腕关节伸展和旋后）（第一组）和FS（腕关节屈曲和旋后）（第二组）。十名观察者必须在100张透视天际线视图上识别SDLR解剖标志（时间1），并在15天后（时间2）再次识别。第一组中四个解剖标志的识别率为78%，第二组为66%（p < 0.001）。四个解剖标志识别的一致性率一般（κ = 0.411）。总之，腕关节伸展和旋后位的垂直透视天际线视图似乎是评估桡骨远端骨折切开复位内固定术中骨折复位质量、桡尺远侧关节和螺钉长度的最合适视图。
