The Dorsal Horizon View: Detecting Screw Protrusion at the Distal Radius

Joseph, Samuel; Harvey, Jason

doi:10.1016/j.jhsa.2011.07.020

Cited by 72 publications

(54 citation statements)

References 11 publications

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“…Four fluoroscopic views [lateral, supination oblique at 45 degrees, pronation oblique at 45 degrees, and dorsal tangential view 18,23 (Fig. 3)] were then obtained of each specimen.…”

Section: Methodsmentioning

confidence: 99%

“…Several radiographic studies have aimed at defining the depth of the valley and describing the optimal fluoroscopic images to judge the screw prominent. [16][17][18][19][20][21][22] None of these studies though have offered a safe screw length to avoid penetration of the dorsal cortex or offered which location on a volar plate is most likely to be prominent.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures

Hill

Shakir

Cannada

2015

Journal of Orthopaedic Trauma

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“…Four fluoroscopic views [lateral, supination oblique at 45 degrees, pronation oblique at 45 degrees, and dorsal tangential view 18,23 (Fig. 3)] were then obtained of each specimen.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures

Hill

Shakir

Cannada

2015

Journal of Orthopaedic Trauma

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“…10 Two skyline techniques have been described for the wrist: one with the forearm supinated and fluoroscope positioned vertically and aimed along the longitudinal axis of the forearm, 5,6 the other with the forearm pronated and fluoroscope positioned horizontally. 9,10 Regardless of the technique, the amount of elbow flexion and extension should be adjusted incrementally to avoid overlapping of the dorsal cortical bone of the radius with the dorsal edge of the carpal bones. 7 The skyline view is the most sensitive X-ray view to detect protrusion of screws that are inserted through a volar locking plate past the dorsal cortical bone of the distal radius.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] There are two published clinical series on the use of this view. 9,10 The purpose of this article is to demonstrate the utility of the skyline fluoroscopic view in detecting screws that penetrate the dorsal cortex of the distal radius that are not apparent on AP and lateral fluoroscopic views.…”

mentioning

confidence: 99%

The Utility of the Fluoroscopic Skyline View During Volar Locking Plate Fixation of Distal Radius Fractures

et al. 2014

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Background?Open reduction and internal fixation (ORIF) using a volar locking plate is a common method for treating displaced distal radius fractures. There is, however, the risk of extensor tendon rupture due to protrusion of the screw tips past the dorsal cortex, which cannot always be adequately seen on a lateral fluoroscopic view. We therefore wished to compare the sensitivity of an intraoperative fluoroscopic skyline view to a lateral fluorosocopic view in detecting past pointing of these screws. Material and Methods?Our series included 75 patients with an average age of 59 years who underwent volar locked plate fixation of a displaced distal radius fracture. Intraoperative anteroposterior (AP), lateral, and skyline fluoroscopic views were performed in each case. The number of screws that were seen to protrude past the dorsal cortex of the distal fracture fragment were recorded for both the lateral and skyline views. The number of screws that required exchange was also documented. Results?No screws were seen to protrude past the dorsal cortical bone on the lateral fluroscopic views. 15 of 300 screws (5%) were seen to protrude past the dorsal cortex by an average of 0.8?mm (range, 0.5 to 2 mm) and were exchanged for shorter screws in 11/75 patients. Conclusion?Our results demonstrate that the skyline is more sensitive than a lateral fluoroscopic view at demonstrating protrusion of the screws in the distal fracture fragment following volar locked plate fixation. Level of Evidence?IV

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“…12,13 Two previous reports described use of this view in a clinical setting without direct visualization of the dorsal cortical screw penetration. 12,14 Therefore, it is unknown whether the dorsal tangential view actually improves the diagnostic accuracy of intraoperative fluoroscopy in detecting dorsal cortical screw penetration. In this cadaveric study, we aimed to determine whether the dorsal tangential view could accurately detect dorsal screw penetration, and to compare the dorsal tangential view with conventional views of the distal radius.…”

mentioning

confidence: 99%

Comparison of 4 Fluoroscopic Views for Dorsal Cortex Screw Penetration After Volar Plating of the Distal Radius

Özer

Wolf

Watkins

et al. 2012

The Journal of Hand Surgery

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The Dorsal Horizon View: Detecting Screw Protrusion at the Distal Radius

Cited by 72 publications

References 11 publications

Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures

Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures

The Utility of the Fluoroscopic Skyline View During Volar Locking Plate Fixation of Distal Radius Fractures

Comparison of 4 Fluoroscopic Views for Dorsal Cortex Screw Penetration After Volar Plating of the Distal Radius

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