Ultrasonography or direct radiography? A comparison of two techniques to detect dorsal screw penetration after volar plate fixation
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CitationÖç, Y., Kılınç, B. E., Gülcü, A., Varol, A., Ertuğrul, R. ve Kara, A. (2018). Ultrasonography or direct radiography? A comparison of two techniques to detect dorsal screw penetration after volar plate fixation. Journal of Orthopaedic Surgery and Research, 13. https://dx.doi.org/10.1186/s13018-018-0774-5
Background: Complications related to extensor tendons have begun to increase with the use of volar plates in the treatment of distal radius fractures. In this study, we aimed to compare four-plane radiography and ultrasonography in the evaluation of dorsal cortex screw penetration following volar plate fixation. Methods: We recruited 47 patients (33 males, 14 females, mean age 37.4 years; range 18-58 years). To evaluate dorsal screw penetration in all patients, we performed radiographs at 45 degrees pronation, 45 degrees supination and obtained dorsal tangential graphs at maximum palmar flexion, and a wrist lateral radiograph. Wrist ultrasonography was performed in all patients. Results: Dorsal screw penetration was detected in 12 of the 47 patients undergoing VLP application. While there was > 2 mm screw penetration in seven patients, there was < 2 mm screw penetration in five patients. On four-plane radiographs, screw penetration > 2 mm was detected in seven patients and screw penetration < 2 mm was detected in two patients. On four-plane radiography, dorsal screw penetration was not detected in three out of five patients, who were shown to have < 2 mm screw penetration by ultrasonography. In addition to perioperative four-plane radiographs are also required to detect dorsal cortex penetration in patients undergoing VLP due to distal radius fracture. However, the detection of screw penetrations < 2 mm is more likely with ultrasonography compared to four-plane radiography. Conclusion: We recommend that dorsal cortex screw penetration should be evaluated with perioperative ultrasonography.