gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Is skyline view accurate for detecting protruded screw in volar plate fixation of distal radius fracture? Compared with intraoperative mobile-mini CT

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  • presenting/speaker Kyunghoon Lim - Wonkwang University Hospital, Iksan, South Korea
  • Byung Taek Kwon - Wonkwang University Hospital, Iksan, South Korea
  • Hongje Kang - Wonkwang University Hospital, Iksan, South Korea

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1528

doi: 10.3205/19ifssh0550, urn:nbn:de:0183-19ifssh05508

Published: February 6, 2020

© 2020 Lim et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

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Objectives/Interrogation: Our purpose is to compare and analyze intraoperative fluoroscopy (skyline view) and mobile-mini computed tomography (CT) for detecting protruded screw in volar locked plating of distal radius fracture.

Methods: We did a prospectively analysis on 20 patients (6 males and 14 females) who had both intraoperative fluoroscopy (skyline view) and mini CT taken, among the patients who had volar locking plate fixation for distal radial fracture at our institution from January 2017 to March. In all cases 4 to 5 locking screws were used at distal row to fix the plate, and skyline view and mobile-mini CT were undergone before pronator quadratus and skin suture. After axial view parallel to the screw was reconstructed on CT, distance between screw tip and dorsal cortex (STCD: screw tip cortex distance) was measured by saving the images on PACS. STCD measured by mobile-mini CT and skyline view were compared.

Results and Conclusions: In skyline view, STCD was 1.68mm, 2.08mm, 2.16mm, 2.84mm, 4.51mm from radial side, respectively. In mobile-mini CT, it was 1.79mm, 1.22mm, 1.20mm, 1.62mm, 5.79mm, respectively. Regarding the 2nd and 3rd screws, STCD measured by skyline view was significantly longer compared to that by mobile-mini CT (p value<0.05). 2 cases showed protruded 3rd screw in CT, while they did not seem so in skyline view. These screws were replaced with shorter ones. In our study, screws looked less protruded at skyline view compared with mobile-mini CT. Additional caution is needed especially when inserting 2nd and 3rd screw.