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HAND
Published in: HAND 4/2014

01-12-2014

Volar locking plate fixation of distal radius fractures: use of an intra-operative ‘carpal shoot through’ view to identify dorsal compartment and distal radioulnar joint screw penetration

Authors: Daniel Marsland, Chris M. Hobbs, Philip S. Sauvé

Published in: HAND | Issue 4/2014

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Abstract

Introduction

We report our experience using a ‘carpal shoot through’ view of the distal radius to identify dorsal compartment screw penetration intra-operatively when performing volar plating of the distal radius.

Methods

A prospective study of 42 patients (mean age 56 years) with acute distal radius fractures treated with open reduction internal fixation was undertaken. Surgical fixation was performed using a volar locking plate in all patients. After plate application, inclined posteroanterior and lateral radiographs were taken followed by the carpal shoot through view.

Results

In six cases (14 %), the carpal shoot through view revealed dorsal screw protrusion, which was not detectable on standard PA and lateral views. In one case, a screw had penetrated the distal radioulnar joint (DRUJ), which was only apparent on the shoot through view. The overall screw exchange rate was 17 %.

Conclusions

Using the hand and carpus to minimise the contrast in X-ray penetration, the dorsal cortex of the distal radius may be imaged intra-operatively and dorsal compartment screw penetration detected in cases with significant multifragmentation when screw measurement is difficult. This view potentially reduces the risk of post-operative pain and extensor tendon injury and also provides excellent visualisation of the DRUJ.
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Metadata
Title
Volar locking plate fixation of distal radius fractures: use of an intra-operative ‘carpal shoot through’ view to identify dorsal compartment and distal radioulnar joint screw penetration
Authors
Daniel Marsland
Chris M. Hobbs
Philip S. Sauvé
Publication date
01-12-2014
Publisher
Springer US
Published in
HAND / Issue 4/2014
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-014-9607-0

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