Yang Jui-Ming, Wang Chien-Kuo, Lin Wei-Chin, Li Chung-Yi, Su Fong-Chin, Jou I-Ming, Wu Po-Ting
Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Department of Orthopedics, Tainan ShinLau Christian Hospital, Tainan, Taiwan.
J Orthop Res. 2023 Jan;41(1):235-240. doi: 10.1002/jor.25341. Epub 2022 Apr 21.
We compared the accuracy of the fluoroscopic dorsal tangential view (DTV) and an ultrasound (US) examination in detecting dorsal screw penetration during volar distal radius plating. In six fresh cadaveric distal radii, seven periarticular locking screws in two rows for each plate were inserted according to the measured length using a depth gauge and then replaced with another that was 1 and 2 mm longer, respectively. The actual protruded length of each screw was determined using computed tomography (CT) images. The accuracy of US and DTV measurements was determined using the intraclass correlation coefficient (ICC), as both measurements were compared with CT measurements. The ICC of US and DTV was 0.96 and 0.75, respectively, for all screws. After excluding the data for proximal-row screws, the ICC of US remained unchanged at 0.96, and that of DTV improved to 0.86. The ICC of US was significantly higher than that of DTV (p < 0.01). US had a 100% detection rate for screw protrusion of more than 1.0 mm. US examination showed excellent consistency with CT measurements and its accuracy was not affected by screw location. US might thus be a practical tool for detecting dorsal cortex screw penetration during volar distal radius plating.
我们比较了透视背侧切线位视图（DTV）和超声（US）检查在检测桡骨远端掌侧钢板固定时背侧螺钉穿出情况的准确性。在6个新鲜尸体的桡骨远端，根据使用深度测量仪测得的长度，为每个钢板插入两排共7枚关节周围锁定螺钉，然后分别用长1毫米和2毫米的另一枚螺钉替换。使用计算机断层扫描（CT）图像确定每枚螺钉的实际突出长度。由于US和DTV测量值均与CT测量值进行比较，因此使用组内相关系数（ICC）来确定US和DTV测量的准确性。所有螺钉的US和DTV的ICC分别为0.96和0.75。排除近端排螺钉的数据后，US的ICC保持不变，仍为0.96，而DTV的ICC提高到0.86。US的ICC显著高于DTV（p＜0.01）。对于突出超过1.0毫米的螺钉，US的检测率为100%。US检查与CT测量显示出极好的一致性，其准确性不受螺钉位置的影响。因此，US可能是检测桡骨远端掌侧钢板固定时背侧皮质螺钉穿出的实用工具。
