The Anterior-Posterior Diameter of Radial Shaft for Predicting Appropriate Length of Distal Screws in Volar Plating for Distal Radius Fractures

Purpose: Extensor tendon complications associated with dorsal screw penetration following volar plating of distal radius fracture have been reported widely. The aim of this study was to find the anatomical index to predict the appropriate length of screw. Methods: Three-dimensional computed tomography (CT) scans of distal radius were performed after removal of volar plate. According to the extensor compartments and Lister tubercle, we divided the distal radius into four groups in axial view in CT. Through sagittal view, we measured volar cortex to dorsal cortex in parallel with the extension of screw trace and anatomical index (lunate depth, anterior-posterior diameter of radius shaft). Statistical analysis was performed with ANOVA and linear regression analysis. Results: The measurable traces of screw were 371 in males and 1,091 in females. The average value was 17.59 mm, 20.72 mm, 20.31 mm, and 19.1 mm in each group for males, and 15.75 mm, 18.76 mm, 18.04 mm, and 17.22 mm for female patients. The anterior-posterior diameter of radius in which the screw was inserted to oblong hole moderately correlated with the extension of screw trace in the third and fourth compartments. Conclusion: The anterior-posterior diameter of radius at level of oblong hole can be used to predict appropriate length of distal screw for volar plating of distal radius fractures.

[1]  C. Goldfarb,et al.  A Prospective Observational Assessment of Unicortical Distal Screw Placement During Volar Plate Fixation of Distal Radius Fractures. , 2018, The Journal of hand surgery.

[2]  Irshad Shakir,et al.  Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures: How Can You Best Detect? , 2015, Journal of orthopaedic trauma.

[3]  W. Mutschler,et al.  The influence of distal screw length on the primary stability of volar plate osteosynthesis—a biomechanical study , 2015, Journal of Orthopaedic Surgery and Research.

[4]  S. Agnew,et al.  Predicting a safe screw length for volar plate fixation of distal radius fractures: lunate depth as a marker for distal radius depth. , 2015, The Journal of hand surgery.

[5]  R. Babst,et al.  The dorsal tangential X-ray view to determine dorsal screw penetration during volar plating of distal radius fractures. , 2015, The Journal of hand surgery.

[6]  N. Schep,et al.  Complications following volar locking plate fixation for distal radial fractures: a systematic review , 2014, The Journal of hand surgery, European volume.

[7]  Il-Jung Park,et al.  Relationship between the Length of Distal Locking Screws and Diaphyseal Screws in Volar Plate Fixation of Distal Radius Fractures , 2013 .

[8]  K. Ozer,et al.  Comparison of 4 fluoroscopic views for dorsal cortex screw penetration after volar plating of the distal radius. , 2012, The Journal of hand surgery.

[9]  Matthew J. Silva,et al.  The effects of screw length on stability of simulated osteoporotic distal radius fractures fixed with volar locking plates. , 2012, The Journal of hand surgery.

[10]  R. Arora,et al.  A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. , 2011, The Journal of bone and joint surgery. American volume.

[11]  K. Ozer,et al.  Dorsal tangential view of the wrist to detect screw penetration to the dorsal cortex of the distal radius after volar fixed-angle plating , 2011, Hand.

[12]  L. Obert,et al.  Anatomical and radiological study applied to distal radius surgery , 2011, Surgical and Radiologic Anatomy.

[13]  G. Windisch,et al.  Computer tomography aided 3D analysis of the distal dorsal radius surface and the effects on volar plate osteosynthesis , 2009, The Journal of hand surgery, European volume.

[14]  T. Messer,et al.  Complications of Volar Plate Fixation for Managing Distal Radius Fractures , 2009, The Journal of the American Academy of Orthopaedic Surgeons.

[15]  W. Grechenig,et al.  Morphometric analysis of lister's tubercle and its consequences on volar plate fixation of distal radius fractures. , 2008, The Journal of hand surgery.

[16]  Rohit Arora,et al.  Complications Following Internal Fixation of Unstable Distal Radius Fracture With a Palmar Locking-Plate , 2007, Journal of orthopaedic trauma.

[17]  P. Evans,et al.  Radiographic Evaluation of Dorsal Screw Penetration After Volar Fixed-Angle Plating of the Distal Radius: A Cadaveric Study , 2007, Hand.

[18]  M. Al-Rashid,et al.  Delayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures. , 2006, The Journal of bone and joint surgery. British volume.

[19]  M. Moneim,et al.  Two Potential Causes of EPL Rupture after Distal Radius Volar Plate Fixation , 2006, Clinical orthopaedics and related research.

[20]  P. Blazar,et al.  Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. , 2006, The Journal of hand surgery.

[21]  M. Henry,et al.  Volar Fixed‐Angle Plating of the Distal Radius , 2005, The Journal of the American Academy of Orthopaedic Surgeons.

[22]  M. Osteaux,et al.  Sonography of a rupture of the tendon of the extensor pollicis longus muscle: initial clinical experience and correlation with findings at cadaveric dissection. , 2005, AJR. American journal of roentgenology.

[23]  D. Bozentka,et al.  Functional Outcomes After Open Reduction and Internal Fixation for Treatment of Displaced Distal Radius Fractures in Patients Over 60 Years of Age , 2004, Journal of orthopaedic trauma.

[24]  H. Drobetz,et al.  Osteosynthesis of distal radial fractures with a volar locking screw plate system , 2002, International Orthopaedics.

[25]  P Regazzoni,et al.  Fractures of the distal radius treated by internal fixation and early function. A prospective study of 73 consecutive patients. , 2000, The Journal of bone and joint surgery. British volume.

[26]  T S Axelrod,et al.  Complications of the AO/ASIF titanium distal radius plate system (pi plate) in internal fixation of the distal radius: a brief report. , 1998, The Journal of hand surgery.

[27]  B. Moed,et al.  Extensor pollicis longus rupture at the tip of a prominent fixation screw: report of three cases. , 1993, The Journal of hand surgery.