Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial
Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs l...
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Lill, Markus [verfasserIn] |
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Englisch |
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2023 |
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© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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Enthalten in: Archives of orthopaedic and trauma surgery - Berlin : Springer, 1903, 144(2023), 1 vom: 19. Sept., Seite 197-204 |
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volume:144 ; year:2023 ; number:1 ; day:19 ; month:09 ; pages:197-204 |
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| DOI / URN: |
10.1007/s00402-023-05046-y |
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SPR054302072 |
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| 520 | |a Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. | ||
| 650 | 4 | |a Distal radius |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Distal radius fracture |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Distal radius surgery complication |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Palmar plating |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Screw length |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Schultes, Philipp |4 aut | |
| 700 | 1 | |a Wierer, Guido |4 aut | |
| 700 | 1 | |a Deml, Christian |4 aut | |
| 700 | 1 | |a Windhofer, Christian |4 aut | |
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10.1007/s00402-023-05046-y doi (DE-627)SPR054302072 (SPR)s00402-023-05046-y-e DE-627 ger DE-627 rakwb eng Lill, Markus verfasserin (orcid)0000-0002-4572-0525 aut Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. Distal radius (dpeaa)DE-He213 Distal radius fracture (dpeaa)DE-He213 Distal radius surgery complication (dpeaa)DE-He213 Palmar plating (dpeaa)DE-He213 Screw length (dpeaa)DE-He213 Schauer, Thomas aut Schultes, Philipp aut Wierer, Guido aut Deml, Christian aut Windhofer, Christian aut Enthalten in Archives of orthopaedic and trauma surgery Berlin : Springer, 1903 144(2023), 1 vom: 19. Sept., Seite 197-204 (DE-627)253390087 (DE-600)1458452-9 1434-3916 nnns volume:144 year:2023 number:1 day:19 month:09 pages:197-204 https://dx.doi.org/10.1007/s00402-023-05046-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 144 2023 1 19 09 197-204 |
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10.1007/s00402-023-05046-y doi (DE-627)SPR054302072 (SPR)s00402-023-05046-y-e DE-627 ger DE-627 rakwb eng Lill, Markus verfasserin (orcid)0000-0002-4572-0525 aut Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. Distal radius (dpeaa)DE-He213 Distal radius fracture (dpeaa)DE-He213 Distal radius surgery complication (dpeaa)DE-He213 Palmar plating (dpeaa)DE-He213 Screw length (dpeaa)DE-He213 Schauer, Thomas aut Schultes, Philipp aut Wierer, Guido aut Deml, Christian aut Windhofer, Christian aut Enthalten in Archives of orthopaedic and trauma surgery Berlin : Springer, 1903 144(2023), 1 vom: 19. Sept., Seite 197-204 (DE-627)253390087 (DE-600)1458452-9 1434-3916 nnns volume:144 year:2023 number:1 day:19 month:09 pages:197-204 https://dx.doi.org/10.1007/s00402-023-05046-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 144 2023 1 19 09 197-204 |
| allfields_unstemmed |
10.1007/s00402-023-05046-y doi (DE-627)SPR054302072 (SPR)s00402-023-05046-y-e DE-627 ger DE-627 rakwb eng Lill, Markus verfasserin (orcid)0000-0002-4572-0525 aut Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. Distal radius (dpeaa)DE-He213 Distal radius fracture (dpeaa)DE-He213 Distal radius surgery complication (dpeaa)DE-He213 Palmar plating (dpeaa)DE-He213 Screw length (dpeaa)DE-He213 Schauer, Thomas aut Schultes, Philipp aut Wierer, Guido aut Deml, Christian aut Windhofer, Christian aut Enthalten in Archives of orthopaedic and trauma surgery Berlin : Springer, 1903 144(2023), 1 vom: 19. Sept., Seite 197-204 (DE-627)253390087 (DE-600)1458452-9 1434-3916 nnns volume:144 year:2023 number:1 day:19 month:09 pages:197-204 https://dx.doi.org/10.1007/s00402-023-05046-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 144 2023 1 19 09 197-204 |
| allfieldsGer |
10.1007/s00402-023-05046-y doi (DE-627)SPR054302072 (SPR)s00402-023-05046-y-e DE-627 ger DE-627 rakwb eng Lill, Markus verfasserin (orcid)0000-0002-4572-0525 aut Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. Distal radius (dpeaa)DE-He213 Distal radius fracture (dpeaa)DE-He213 Distal radius surgery complication (dpeaa)DE-He213 Palmar plating (dpeaa)DE-He213 Screw length (dpeaa)DE-He213 Schauer, Thomas aut Schultes, Philipp aut Wierer, Guido aut Deml, Christian aut Windhofer, Christian aut Enthalten in Archives of orthopaedic and trauma surgery Berlin : Springer, 1903 144(2023), 1 vom: 19. Sept., Seite 197-204 (DE-627)253390087 (DE-600)1458452-9 1434-3916 nnns volume:144 year:2023 number:1 day:19 month:09 pages:197-204 https://dx.doi.org/10.1007/s00402-023-05046-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 144 2023 1 19 09 197-204 |
| allfieldsSound |
10.1007/s00402-023-05046-y doi (DE-627)SPR054302072 (SPR)s00402-023-05046-y-e DE-627 ger DE-627 rakwb eng Lill, Markus verfasserin (orcid)0000-0002-4572-0525 aut Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. Distal radius (dpeaa)DE-He213 Distal radius fracture (dpeaa)DE-He213 Distal radius surgery complication (dpeaa)DE-He213 Palmar plating (dpeaa)DE-He213 Screw length (dpeaa)DE-He213 Schauer, Thomas aut Schultes, Philipp aut Wierer, Guido aut Deml, Christian aut Windhofer, Christian aut Enthalten in Archives of orthopaedic and trauma surgery Berlin : Springer, 1903 144(2023), 1 vom: 19. Sept., Seite 197-204 (DE-627)253390087 (DE-600)1458452-9 1434-3916 nnns volume:144 year:2023 number:1 day:19 month:09 pages:197-204 https://dx.doi.org/10.1007/s00402-023-05046-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4277 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 144 2023 1 19 09 197-204 |
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Enthalten in Archives of orthopaedic and trauma surgery 144(2023), 1 vom: 19. Sept., Seite 197-204 volume:144 year:2023 number:1 day:19 month:09 pages:197-204 |
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Enthalten in Archives of orthopaedic and trauma surgery 144(2023), 1 vom: 19. Sept., Seite 197-204 volume:144 year:2023 number:1 day:19 month:09 pages:197-204 |
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Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. 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Lill, Markus |
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Lill, Markus misc Distal radius misc Distal radius fracture misc Distal radius surgery complication misc Palmar plating misc Screw length Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial |
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Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial Distal radius (dpeaa)DE-He213 Distal radius fracture (dpeaa)DE-He213 Distal radius surgery complication (dpeaa)DE-He213 Palmar plating (dpeaa)DE-He213 Screw length (dpeaa)DE-He213 |
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avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial |
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Avoiding screw overlength using dorsal horizon view in palmar plate osteosynthesis of distal radius fractures: a prospective randomized trial |
| abstract |
Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
| abstractGer |
Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
| abstract_unstemmed |
Introduction Distal radius fractures are the most commonly reported fractures in adults. Treatment has changed in recent years to open reduction and palmar plate fixation. Penetration of the dorsal screw, however, is a well-known complication. Intraoperative anteroposterior and lateral radiographs lack the exact assessment of dorsal screw length and intraoperative measurement is therefore very likely to be inaccurate in a comminuted dorsal radial cortex. Secondary extensor tendon ruptures are reported in up to 6% following palmar plate fixation of distal radius fracture. Materials and methods A prospective randomized trial was performed to assess the value of the dorsal horizon view. The hypothesis was that the traditional anteroposterior and lateral fluoroscopic views aided by an axial view of the dorsal part of the radius, named dorsal horizon view, could prevent dorsal screw penetration. A total of 40 patients, 6 male and 34 female, were included in the study. Standardized anteroposterior and lateral radiographs were performed intraoperatively in 18 patients (standard group = control group). In 22 patients, intraoperative axial fluoroscopic views (dorsal horizon view) were added to anteroposterior and lateral images (horizon group). Numbers of intraoperative screw changes due to the two different radiological examinations were analyzed as well as exact postoperative CT guided measurement of screw length. Results The total numbers of intraoperative screw changes were significantly higher in the horizon group. Forty-two screws were changed in 15 patients in the horizon group while only 8 screws were changed in 3 patients in the standard group. Postoperative computed tomography scans showed significantly lower total numbers of perforating screws in the horizon group with 11 screws in 22 patients compared to 20 screws in 18 patients in the standard group (p = 0.02). Conclusions Based on the results of this study, the dorsal horizon view improves the assessment of the correct screw length and should routinely be used in palmar plate osteosynthesis of distal radius fractures. Since screw protrusion cannot be absolutely ruled out using the dorsal horizon view, monocortical drilling or screw downsizing is still mandatory. Trial registration This clinical trial was not registered because it was a clinical examination without any experimental techniques. Level of evidence 2. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| score |
7.4008465 |