Comparison of ultrasound and dorsal horizon radiographic view for the detection of dorsal screw penetration

Gürbüz, Yusuf; Küçük, Levent; Günay, Hüseyin; Ozaksar, Kemal; Sügün, Tahir Sadık; Bilge, Okan

doi:10.1016/j.aott.2017.10.004

Cited by 14 publications

(17 citation statements)

References 15 publications

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“…Additionally, using the VLP have an excellent advantage of biomechanics in treatment for the DRFs, but none of the recommendations in clinical practice guidelines for DRFs published by the American Academy of Orthopaedic Surgeons (AAOS) was given a “strong” rating owing to limited strength of the evidence. Furthermore, there were some complications related to VLP, such as flexor tendon problem, 8 longitudinal fractures of the near cortex, 9 tenosynovitis and tendon ruptures resulting from penetration of distal screws through the dorsal cortex 10 and so on. Therefore, whether VLP are superior to EF in clinical results in the treatment for DRFs remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis

Wang¹,

Lu²,

Cui³

et al. 2018

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this meta-analysis of randomized controlled trials (RCT) and retrospective cohort studies (CS) regarding the use of volar locking plate (VLP) and external fixation (EF) in distal radius fractures was to determine whether there was any evidence that one treatment was superior to the other.MethodsThe meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electrical databases (PubMed, EMBASE and the Cochrane library) were retrieved to find RCTs and CSs met the eligibility criteria. Two reviewers screened the studies, extracted the data and evaluated the methodological quality, and performed data analysis with RevMan 5.1. The publication bias was test by Stata 14.0. The Begg's and Egger's test were performed by Stata 14.0. The quality of evidence was graded according to the criteria of GRADE. We ultimately included ten RCTs and eleven CSs.ResultsA total of 1590 subjects were reported. Publication bias was detected by funnel plot in RCTs. VLP could provide better results such as DASH scores (RCT: MD = −6.12, 95%CI = −12.07–0.17; CS: MD = −6.43, 95%CI = −12.53–0.3), ulnar variance (RCT: MD = −0.81, 95%CI = −1.25–0.37) and infection rate (RCT: RR = 0.25, 95%CI = 0.10–0.65; CS: RR = 0.15, 95%CI = 0.06–0.40). There were no significant differences for G-W scores, VAS and grip strength between the VLP group and EF group. There was significantly greater loss of volar tilt (P = 0.01) and radial inclination (P = 0.02) in patients receiving EF, basing on the CSs.ConclusionsVLP could provide better results, such as DASH scores, ulnar variance, volar tilt, radial inclination and infection rate. The use of VLP appear to be associated with better results of ROM (flexion, pronation, supination and radial deviation), radiographic parameters (volar tilt and radial inclination) and lower total complication rate and CRPS rate in CSs.Level of evidenceLevel 1, Therapeutic study.

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Section: Introductionmentioning

confidence: 99%

Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis

Wang¹,

Lu²,

Cui³

et al. 2018

Acta Orthopaedica et Traumatologica Turcica

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“…There are two described techniques to achieve DTV. The fi rst (and mostly used) is with the supinated forearm inclined at 15° to the vertical X-ray beam with maximum wrist fl exion (8,12,13,21,(23)(24)(25)(26). The second is with a pronated forearm and horizontally placed fl uoroscope with the X-ray beam parallel to the dorsal aspect of the distal radius (9,27).…”

Section: Discussionmentioning

confidence: 99%

What are the ideal screw lengths in volar locking plate fixation for distal radius fractures?

Kilian¹,

Simkovic²,

Zamborský³

et al. 2019

BLL

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PURPOSE: This study aimed to specify the optimal lengths of the distal locking screws (in a female population undergoing distal radius fracture fi xation with a volar locking plate) to avoid damaging the dorsal extensor tendon compartments while preserving stability. METHODS: Twenty-fi ve female adult patients underwent volar locking plate fi xation with four 2.4 mm locking screws inserted distally. Our modifi ed dorsal tangential fl uoroscopic view (DTV) was taken perioperatively followed by postoperative CT scans to compare the accuracy in determining the distal screw lengths. RESULTS: Our modifi ed DTV was 88 %, 84 %, 88 %, and 76 % sensitive in detecting screw lengths in the fi rst, second, third, and fourth distal plate holes, respectively. According to the CT scans, none of the screws were over-penetrated in the third dorsal compartment, over-penetration was found in the second and fourth dorsal compartment. The most-accurate screw lengths in the four most distal plate holes in female distal radius fracture are 14, 20, 20, and 20 mm from the radial to the ulnar aspect. CONCLUSION: In dorsal cortex comminution, when perioperative measuring is imprecise, inserting the mostsuitable distal locking screw for problematic hole and then applying our modifi ed DTV seems to be a simpler and safer option (Tab.

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“…Sugun et al [50] stated the use of ultrasound has detected 59 screws that were protruding with 0.5mm or more from the dorsal cortex of distal radius from the 230 locking screw that were located at the distal rows of the locking plate. Gurbuz et al [51] studies have discover that the accuracy to detect screw penetration for 1mm was 87% in ultrasonography.…”

Section: Assessment Of Screw-bone Implantmentioning

confidence: 98%

“…The ultrasound diagnostic have been discovered to have the sensitivity of 97.9% with a specificity of 95% for the scan of an elbow fracture and have the accuracy to estimate the fracture displacement adequately by Eckert et al [57]. This proves that ultrasonic imaging is an excellent alternative compared to radiography which when used periodically can cause harm to human due to the radiation emission [51], [57]. The detection of fracture the sensitivity of ultrasound is 92.9% and a specificity of 99.5% which is comparable to the detection using X-ray that have the sensitivity of 93.2 and specificity of 99.8% have been reported by Moritz et al [58].…”

Section: Ultrasound In Bonementioning

confidence: 98%

“…Sanden et al [53] have defined that 1mm is the threshold for screw loosening and reported that the probabilities to detect a loose screw using radiological examination was 64% with the specificity of 100%. Gurbuz et al [51] and Haug et al [52] stated the rate for detecting screw penetration for 1 mm by using dorsal horizontal view was 71% and 86.7% respectively. The rate of loosening identified from the 42 patients by the use or radiographic loosening criteria is 19.7% which is equivalent to 14 patients [54].…”

Section: Radioghraphy In Bonementioning

confidence: 99%

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Screw-Bone Implant Loosening: Complication, Cause and Assessment

Ghani¹,

Hassan²,

Daud³

2018

IJET

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Bone fracture has become more common in this era of vehicular modernization. Internal fixation has been used in the treatment of such cases. The use of screw and plate in internal fixation has been proven to provide more stability to fracture to promote better healing. The use of screw also carries certain risk such as self-loosening that can cause non-union and prolong healing. The complication of selfloosening is studied to comprehend the danger of self-loosening in screw-bone implant. The review on self-loosening in bolted joint is done in this paper to gain better understanding on the nature of self-loosening phenomena. The factor that affects the screw selfloosening in bone is further studied in the screw-bone implant environment. The identification of the screw loosening can be done with radiography, CT scan, MRI and ultrasound. This article have done a brief review on the complication of screw self-loosening, the cause of screw loosening in bolted joint and screw-bone implant and the assessment of screw loosening done by ultrasound and radiography.

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Comparison of ultrasound and dorsal horizon radiographic view for the detection of dorsal screw penetration

Cited by 14 publications

References 15 publications

Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis

Is volar locking plate superior to external fixation for distal radius fractures? A comprehensive meta-analysis

What are the ideal screw lengths in volar locking plate fixation for distal radius fractures?

Screw-Bone Implant Loosening: Complication, Cause and Assessment

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