Improving Accuracy and Confidence in Distal Radius Volar Plate Screw Placement through Supplemental Radiography: Examining Specialty, Education, and Experience Levels

Abstract

A supplemental view of the distal radius combined with AP and lateral views significantly improves the ability of all evaluators, regardless of specialty or training level, to correctly assess placement of fixation screws. The greatest improvements are seen for resident trainees.

Volar Plating: Imaging Modalities for the Detection of Screw Penetration

“…Patel et al performed a survey of conventional and tilt views of 34 patients among 65 physicians. 41 They found that adding a 30-degree tilt lateral view to lateral and AP views increases the accuracy by 19%. 41 Sensitivity, specificity, and/or accuracy per imaging modality can be found in ►Table 5.…”

“…41 They found that adding a 30-degree tilt lateral view to lateral and AP views increases the accuracy by 19%. 41 Sensitivity, specificity, and/or accuracy per imaging modality can be found in ►Table 5.…”

“…The accuracy for the detection of intra-articular screw penetration is reported in three clinical studies. 37,39,41 Kumar et al reported only tilted lateral and AP views correctly showed no screws to penetrate the joint in 10 patients, which would result in a specificity of 100%. 37 No reference standard was described in this study.…”

“…Nine studies analyzed imaging modalities detecting intraarticular screw penetration. 7,12,[35][36][37][38][39][40][41] Six studies were in vitro (cadaveric) studies, and three were in vivo (clinical) studies. Study characteristics of all studies reporting on the detection of intra-articular screw penetration can be found in ►Supplementary Appendix 5.…”

“…Three studies analyzed imaging modalities for detection of intra-articular screw penetration in a clinical setting. 37,39,41…”