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Comparison of lateral and skyline fluoroscopic views for detection of prominent screws in distal radius fractures plating: results of an ultrasonographic study

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Extensor tendon rupture is a recognized complication of volar plate fixation of distal radius fractures due to screws protruding past the dorsal cortex. The aim of this study was to compare the Skyline view with traditional lateral fluoroscopic views using ultrasonography as a reference standard in the postoperative assessment.

Materials and methods

A monocentric prospective study was conducted to identify screws penetrating the dorsal cortex after volar plating of distal radius fractures.

Patients and intervention

Intraoperative anteroposterior (AP) and lateral views were used for group A (28 patients). AP, lateral and skyline fluoroscopic views were used for Group B (40 patients). Prominent screws were changed. Main outcome measurements: Ultrasound was done 6 months postoperatively to evaluate the number and length of prominent dorsal screws and any signs of extensor tenosynovitis.

Results

The number of prominent dorsal screws exceeding 1 mm was 14 in group A (14.9%), and 16 screws (11.8%) in group B (p = 0.487). Average length of prominent dorsal screw was 1.9 mm (range 1–2.1 mm) for group A and 2.4 mm (range 1.1–4.8 mm) for group B (p = 0.534). The number of patients with extensor tenosynovitis was 11 for group A and 12 for group B (p = 0.66).

Conclusions

The Skyline view does not provide sensitive and reliable detection of the dorsal screw penetration. Intraoperative ultrasound might be a better tool to detect screw prominence.

Level of evidence

III, case–control study.

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Authors and Affiliations

  1. Orthopedics and Hand Surgery Department, Saint-Antoine Hospital, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France

    Olivier Herisson, Caroline Delaroche, Sandrine Maillot-Roy, Alain Sautet, Levon Doursounian & Adeline Cambon-Binder

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  1. Olivier Herisson
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  2. Caroline Delaroche
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  3. Sandrine Maillot-Roy
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  4. Alain Sautet
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  5. Levon Doursounian
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Correspondence to Olivier Herisson.

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Informed consent was obtained from all individual participants included in the study.

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Herisson, O., Delaroche, C., Maillot-Roy, S. et al. Comparison of lateral and skyline fluoroscopic views for detection of prominent screws in distal radius fractures plating: results of an ultrasonographic study. Arch Orthop Trauma Surg 137, 1357–1362 (2017). https://doi.org/10.1007/s00402-017-2759-y

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  • DOI: https://doi.org/10.1007/s00402-017-2759-y

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