Morphometric anatomic study and clinical significance of lunate fossa

Aldemir, Cengiz; Önder, Merve; Doğan, Ali; Duygun, Fatih; Oğuz, Nurettin

doi:10.5606/ehc.2015.07

Cited by 2 publications

(1 citation statement)

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“…Factors which can lay the ground for and result in intra-articular penetration of the screws include plate design (distal mobile screw holes, non-angulated free holes, incompatibility of the plate and distal radius volar interface), application errors (inattention to the watershed line during application of the plate, incorrect positioning of the plate), inattention to the depth of the lunate fossa, and super-positioning of the screws. [2,3] When applying a volar distal radius plate, there are five important anatomic formations that require attention; the volar radial tuberosity, volar radial ridge, fibrous transition zone, watershed line, and the lunate facet buttress. [4] Another point which has been described in respect of ideal placement of the plate and collapse which could occur in the future is the distal dorsal cortical distance, which should be 6 mm or less.…”

Section: Objectivesmentioning

confidence: 99%

Is it possible to avoid intra-articular screw penetration with minimal use of fluoroscopy in the application of distal radius volar plate?

Aldemir¹

2017

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada distal radius volar plak uygulamasında minimum floroskopi kullanılarak eklem içi vida penetrasyonundan kaçınmanın ve böylece cerrahi ekibin radyasyona maruz kalma riskinin minimuma indirilmesinin mümkün olup olmadığı araştırıldı. Hastalar ve yöntemler: Haziran 2014 -Mayıs 2016 tarihleri arasında instabil distal radius kırığı olan 50 hastada (22 erkek, 28 kadın; ort. yaş 43.52 yıl; dağılım 18-76 yıl) kırık redüksiyonunu takiben distal vida ile volar plak uygulaması minimum floroskopi kullanımı ile gerçekleştirildi. Özel tasarlanmış volar anatomik plak lunat fossanın fasetinin ucundan proksimale doğru 3 mm mesafe oluşturularak uygulandı. Bulgular: Vida yataklarına özel açı verilerek tasarlanmış plak ile tarif edilen cerrahi tekniğe dikkat ederek ve minimum düzeyde floroskopi kullanarak yaptığımız plakvida uygulamalarında eklem içi vida komplikasyonu ile karşılaşılmadı. Ameliyat sırasında floroskopi minimum düzeyde uygulandı ve eklem içi vida kullanımını düşündürecek herhangi bir bulguya rastlanmadı. Ameliyat sırasında ve sonrasında el bileği hareketlerinde kısıtlılık, takılma ya da sürtünme bulgularına rastlanmadı. Sonuç: Volar plak ve distal kilit vida yatağı tasarımındaki iyileştirmeler ile eklem içi vida komplikasyonları olasılığını ve erken dönem tekrar cerrahi düzeltme ihtiyacını ortadan kaldırmak ve cerrahi ekibin radyasyona maruz kalma riskini minimuma indirmek mümkündür.Anahtar sözcükler: Distal radius kırığı; floroskopi, volar anatomik plak. ABSTRACTObjectives: This study aims to investigate whether or not it is possible to avoid intra-articular screw penetration in the application of distal radius volar plate with minimal use of fluoroscopy and thereby reduce to a minimum the risk of exposure of the surgical team to radiation. Patients and methods: Volar plate with distal screw application with minimal use of fluoroscopy was performed in a total of 50 patients (22 males, 28 females; mean age 43.52 years; range 18 to 76 years) with unstable distal radius fracture following reduction of fracture between June 2014 and May 2016. A specially designed volar anatomic plate was applied by creating a 3 mm gap proximal from the tip of the facet of the lunate fossa. Results: No intra-articular screw complication was observed during plate-screw applications that we performed by using fluoroscopy at a minimum level and paying attention to the surgical technique described with the plate designed by giving a specific angle to screw beds. During the operation, fluoroscopy was performed at a minimum level and no finding was observed which could suggest use of intra-articular screw. No findings of restriction in wrist movements, locking or friction were observed intra-or postoperatively. Conclusion: With improvements in the design of the volar plate and the distal locking screw bed, it is possible to rule out the possibility of intra-articular screw complications and the need for surgical re-correction in the early-term, and to reduce to a minimum the risk of exposure of the surgical team to radiation.

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Section: Objectivesmentioning

confidence: 99%