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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 5/2022

Open Access 08-10-2021 | Distal Radius Fracture | Original Article

3D virtual pre-operative planning may reduce the incidence of dorsal screw penetration in volar plating of intra-articular distal radius fractures

Authors: Jasper Prijs, Bram Schoolmeesters, Denise Eygendaal, Jean-Paul P. M. de Vries, Paul C. Jutte, Job N. Doornberg, Ruurd L. Jaarsma, Frank F. A. IJpma, on behalf of the Traumaplatform 3D Consortium

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2022

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Abstract

Purpose

To evaluate the effect of three-dimensional virtual pre-operative planning (3DVP) on the incidence of dorsal screw penetration after volar plating of distal radius fractures.

Methods

A cross-sectional diagnostic imaging study was performed. Twenty out of 50 patients were randomly selected from our index prospective cohort (IPC): a prior study evaluating dorsal tangential views (DTVs) in reducing dorsal screw penetration in internal fixation of intra-articular distal radius fractures using post-operative CT scans to quantify screw protrusion. Pre-operative CTs from this cohort were now used for 3DVP by three experienced orthopaedic trauma surgeons (supplementary video). 3DVP was compared with the corresponding post-operative CT for assessing screw lengths and incidence of dorsal penetration. The Wilcoxon Signed Ranks test was used to compare screw lengths and the Fishers’ exact for incidence of penetration.

Results

Three surgeons performed 3DVP for 20 distal radius fractures and virtually applied 60 volar plates and 273 screws. Median screw length was shorter in the 3DVP when compared to IPC: 18 mm (range, 12–22) versus 20 mm (range, 14–26) (p < 0.001). The number of penetrating screws was 5% (13/273 screws) in the 3DVP group compared to 11% (10/91 screws) in the IPC (p = 0.047). Corresponding to a reduction in incidence of at least one dorsally penetrating screw in 40% of patients in the IPC group, to 18% in the 3DVP group (p = 0.069).

Conclusion

Three-Dimensional Virtual Pre-Operative Planning (3DVP) may reduce the incidence of dorsally penetrating screws in patients treated with volar plating for intra-articular distal radius fractures.

Level of evidence

II, diagnostic imaging study.
Appendix
Available only for authorised users
Literature
1.
Langerhuizen DWG, et al. Diagnosis of dorsal screw penetration after volar plating of a distal radial fracture. Bone Joint J. 2020;102-B(7):874–80.CrossRef
2.
McKay SD, et al. Assessment of complications of distal radius fractures and development of a complication checklist. J Hand Surg Am. 2001;26(5):916–22.CrossRef
3.
Bergsma M, et al. Volar plating in distal radius fractures: a prospective clinical study on efficacy of dorsal tangential views to avoid screw penetration. Injury. 2018;49(10):1810–5.CrossRef
4.
Ozer K, Toker S. Dorsal tangential view of the wrist to detect screw penetration to the dorsal cortex of the distal radius after volar fixed-angle plating. Hand (N Y). 2011;6(2):190–3.CrossRef
5.
Arora R, et al. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21(5):316–22.CrossRef
6.
Sugun TS, et al. Screw prominences related to palmar locking plating of distal radius. J Hand Surg Eur. 2011;36(4):320–4.CrossRef
7.
Diong TW, et al. Use of computed tomography in determining the occurrence of dorsal and intra-articular screw penetration in volar locking plate osteosynthesis of distal radius fracture. J Hand Surg Asian Pac. 2018;23(1):26–32.CrossRef
8.
Bentohami A, et al. Complications following volar locking plate fixation for distal radial fractures: a systematic review. J Hand Surg Eur. 2014;39(7):745–54.CrossRef
9.
Bergsma M, et al. A prospective cohort study on accuracy of dorsal tangential views to avoid screw penetration with volar plating of distal radius fractures. J Orthop Trauma. 2020;34(9):e291–7.CrossRef
10.
Bergsma M, et al. Accuracy of dorsal tangential views to avoid screw penetration with volar plating of distal radius fractures. J Orthop Trauma. 2020;34(9):e291–7.CrossRef
11.
Bergsma M, et al. Volar plating: imaging modalities for the detection of screw penetration. J Wrist Surg. 2019;8(6):520–30.CrossRef
12.
de Muinck Keizer RJO, et al. Three-dimensional virtual planning of corrective osteotomies of distal radius malunions: a systematic review and meta-analysis. Strategies Trauma Limb Reconstr. 2017;12(2):77–89.CrossRef
13.
Stockmans F, Dezillie M, Vanhaecke J. Accuracy of 3D virtual planning of corrective osteotomies of the distal radius. J Wrist Surg. 2013;2(4):306–14.CrossRef
14.
Chen Y, et al. Computer-assisted virtual surgical technology versus three-dimensional printing technology in preoperative planning for displaced three and four-part fractures of the proximal end of the humerus. J Bone Joint Surg Am. 2018;100(22):1960–8.CrossRef
15.
Assink N, et al. Quantitative 3D measurements of tibial plateau fractures. Sci Rep. 2019;9(1):14395.CrossRef
16.
Merema BJ, et al. The design, production and clinical application of 3D patient-specific implants with drilling guides for acetabular surgery. Injury. 2017;48(11):2540–7.CrossRef
17.
Yoshii Y, et al. Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures. J Orthop Res. 2017;35(12):2646–51.CrossRef
18.
Totoki Y, et al. Screw length optimization of a volar locking plate using three dimensional preoperative planning in distal radius fractures. J Hand Surg Asian Pac. 2018;23(4):520–7.CrossRef
19.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRef
20.
Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1994;6(4):284–90.CrossRef
21.
22.
23.
Nieboer P, et al. Recruiting expertise: how surgical trainees engage supervisors for learning in the operating room. Med Educ. 2019;53(6):616–27.CrossRef
24.
Logishetty K, Rudran B, Cobb JP. Virtual reality training improves trainee performance in total hip arthroplasty: a randomized controlled trial. Bone Joint J. 2019;101-B(12):1585–92.CrossRef
Metadata
Title
3D virtual pre-operative planning may reduce the incidence of dorsal screw penetration in volar plating of intra-articular distal radius fractures
Authors
Jasper Prijs
Bram Schoolmeesters
Denise Eygendaal
Jean-Paul P. M. de Vries
Paul C. Jutte
Job N. Doornberg
Ruurd L. Jaarsma
Frank F. A. IJpma
on behalf of the Traumaplatform 3D Consortium
Publication date
08-10-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 5/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-021-01800-2

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