Screw Length in Volar Locking Plate Fixation for Distal Radial Fractures

Yuen, Grace; Yee, Dennis Kh; Fang, Christian; Lau, Tak-Wing; Leung, Frankie

doi:10.1177/230949901502300209

Cited by 5 publications

(10 citation statements)

References 15 publications

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“…The measurements of the epiphyseal screws lengths in the entire cohort are in accordance with a previous study by Yuen et al. (2015) on 12 East Asian cadaveric specimens.…”

Section: Discussionsupporting

confidence: 90%

“…Besides determining the appropriate epiphyseal screw lengths, these figures can also be used to avoid penetration of the posterior cortex while drilling, thus reducing fluoroscopic radiation during surgery and minimizing the risk of intra-operative soft tissue injuries. The measurements of the epiphyseal screws lengths in the entire cohort are in accordance with a previous study by Yuen et al (2015) on 12 East Asian cadaveric specimens. Yuen et al (2015) reported mean Ulnar 1, Ulnar 2, Radial 3 and Radial 4 screw lengths of 20 mm, 20.8 mm, 19.6 mm and 15.4 mm, respectively.…”

Section: Discussionsupporting

confidence: 90%

“…(2015) on 12 East Asian cadaveric specimens. Yuen et al. (2015) reported mean Ulnar 1, Ulnar 2, Radial 3 and Radial 4 screw lengths of 20 mm, 20.8 mm, 19.6 mm and 15.4 mm, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Most surgeons rely on intra-operative measurement and fluoroscopic verification of plate positioning and screw lengths. However, because of the trapezoidal shape of the distal radius, evaluation of the epiphyseal screw length may be difficult on standard radiographic views (Haug et al, 2013;Vaiss et al, 2014;Yuen et al, 2015). Vaiss et al (2014) highlighted the usefulness of intra-operative (during surgery time).…”

Section: Introductionmentioning

confidence: 99%

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Predicting epiphyseal screw length in anterior plating of distal radial fractures

Letissier

Dardenne

Stindel

et al. 2019

J Hand Surg Eur Vol

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The purpose of this study was to determine whether optimal epiphyseal screw length could be predicted with reference to a given diaphyseal screw length when fixating a plate to the anterior surface of the distal radius. Computerized tomography scans of 40 wrists of 28 men and 12 women were semi-automatically segmented. A virtual anterior plate model was fixed to the distal radius. The mean maximal appropriate length of one diaphyseal screw and of the four distal epiphyseal screws were measured and linear regression analyses were performed. We found that the epiphyseal screw lengths were highly correlated to the diaphyseal screw length. Based on the data derived from measurements, we recommend epiphyseal screw lengths from ulnar to radial of 18, 18, 20 and 16 mm, respectively, if the diaphyseal screw is 14 mm or less. For diaphyseal screws longer than 14 mm we recommend epiphyseal screws of 20, 20, 22 and 18 mm. Using these recommended screw lengths as general guidelines may reduce the risk of intra-operative and postoperative extensor tendon injury.

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“…The measurements of the epiphyseal screws lengths in the entire cohort are in accordance with a previous study by Yuen et al. (2015) on 12 East Asian cadaveric specimens.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

“…(2015) on 12 East Asian cadaveric specimens. Yuen et al. (2015) reported mean Ulnar 1, Ulnar 2, Radial 3 and Radial 4 screw lengths of 20 mm, 20.8 mm, 19.6 mm and 15.4 mm, respectively.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predicting epiphyseal screw length in anterior plating of distal radial fractures

Letissier

Dardenne

Stindel

et al. 2019

J Hand Surg Eur Vol

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show abstract

“…According to the literature, screw penetration greater than 1.0 mm is likely to cause problems (7,16). Therefore, some authors have proposed that distal screws should be routinely 2-4 mm shorter than measured (5,10,23,28,29) and that a screw length of 75 % of the distal radius bone offers fi xation that is as strong as a bicortical construct (30). However, the comminution of the DC usually prevents an adequate drilling through opposite cortex and accurate depth-gauge measurement, and calculating 75 % of an unknown screw measurement is quite tricky.…”

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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Traditional radiography versus computed tomography to assess reduced distal radius fractures

Dankelman,

Barvelink,

Verhofstad

et al. 2024

Eur J Trauma Emerg Surg

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Introduction This study compares computed tomography (CT) with plain radiography in its ability to assess distal radius fracture (DRF) malalignment after closed reduction and cast immobilization. Methods Malalignment is defined as radiographic fracture alignment beyond threshold values according to the Dutch guideline encompassing angulation, inclination, positive ulnar variance and intra-articular step-off or gap. After identifying 96 patients with correct alignment on initial post-reduction radiographs, we re-assessed alignment on post-reduction CT scans. Results Significant discrepancies were found between radiographs and CT scans in all measurement parameters. Notably, intra-articular step-off and gap variations on CT scans led to the reclassification of the majority of cases from correct alignment to malalignment. CT scans showed malalignment in 53% of cases, of which 73% underwent surgery. Conclusion When there is doubt about post-reduction alignment based on radiograph imaging, additional CT scanning often reveals malalignment, primarily due to intra-articular incongruency.

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Screw Length in Volar Locking Plate Fixation for Distal Radial Fractures

Cited by 5 publications

References 15 publications

Predicting epiphyseal screw length in anterior plating of distal radial fractures

Predicting epiphyseal screw length in anterior plating of distal radial fractures

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

Traditional radiography versus computed tomography to assess reduced distal radius fractures

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