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BMC Musculoskeletal Disorders

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Open Access 01-12-2018 | Research article

Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study

Authors: Qiuke Wang, Yifei Liu, Ming Zhang, Yu Zhu, Lei Wang, Yunfeng Chen

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

Abstract

Background

To identify the optimal viewing angles for every proximal screw in PHILOS plate-fixed proximal humeral fractures.

Methods

Three fresh-frozen human cadaveric bodies with six intact shoulders were studied. All three bodies were put in the beach chair position and PHILOS plates were placed on the proximal humerus. Head screws penetrating 1 mm into the joint were fitted one by one. Fluoroscopy was conducted in the 180° horizontal plane and the 120° coronal plane to analyze each screw’s penetration in every shoulder. Images were taken every 5°, then all images were analyzed to identify the sensitive angles.

Results

The range of optimal viewing angles to visualize penetration of every head screw was identified. In the coronal plane, the angles in the range between 0° and 10° were sensitive to all screws except No. 8 and No. 9. Furthermore, penetration of screws No. 8 and 9 could not be identified on any axillary view, but could be identified in the horizontal plane from − 30° to − 10° and from 10° to 35° respectively.

Conclusions

We recommend a 0°–10° axillary view with 30° arm abduction combined with two horizontal angles in the range of − 30° to − 10° and 10° to 35° for routine fluoroscopy during surgery. Our results will be helpful in avoiding primary screw penetration.

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Title: Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study
Authors: Qiuke Wang
Yifei Liu
Ming Zhang
Yu Zhu
Lei Wang
Yunfeng Chen
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-018-2247-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Optimal viewing angles of intraoperative fluoroscopy for detecting screw penetration in proximal humeral fractures: a cadaveric study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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