Intraoperative C-arm CT imaging in angular stable plate osteosynthesis of distal radius fractures

2013 ◽  
Vol 38 (7) ◽  
pp. 751-757 ◽  
Author(s):  
I. Mehling ◽  
P. Rittstieg ◽  
A. P. Mehling ◽  
R. Küchle ◽  
L. P. Müller ◽  
...  
Keyword(s):  
Distal Radius ◽  
Plate Osteosynthesis ◽  
Three Dimensional ◽  
Exposure Dose ◽  
Ct Imaging ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radiation Exposure Dose ◽  
Volar Plate Osteosynthesis

The purpose of this study was to analyze the practicability and benefit of intraoperative C-arm computed tomography (CT) imaging in volar plate osteosynthesis of unstable distal radius fractures. During a 1 year period, intraoperative three dimensional (3D) imaging with the ARCADIS Orbic 3D was performed in addition to standard fluoroscopy in 51 cases. The volar angular stable plate oesteosyntheses were analyzed intraoperatively and, if necessary, improved immediately. The duration of the scan and radiation exposure dose were measured. On average, performance of the scan and analysis of the CT dataset took 6.7 minutes. In 31.3% of the surgeries a misplacement of screws was detected and correction was done immediately. C-arm CT imaging can easily be integrated in the normal course of surgery. As a complement to the standard 2D-fluoroscopy, the C-arm CT is a useful tool to evaluate the quality of osteosynthesis.

scholarly journals Comparison of a ceiling-mounted 3D flat panel detector vs. conventional intraoperative 2D fluoroscopy in plate osteosynthesis of distal radius fractures with volar locking plate systems

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Raphael Seuthe ◽  
Andreas Seekamp ◽  
Bodo Kurz ◽  
Julian Pfarr ◽  
Jost Philipp Schaefer ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Distal Radius Fractures ◽  
Fracture Reduction ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
Flat Panel ◽  
Flat Panel Detector

Abstract Objectives To compare intraoperative 3D fluoroscopy with a ceiling-mounted flat panel detector in plate osteosynthesis of distal radius fractures (AO/OTA 2R3C1.2) with volar locking plate systems to conventional 2D fluoroscopy for detection of insufficient fracture reduction, plate misplacement and protruding screws. Methods Using a common volar approach on 12 cadaver forearms, total intraarticular distal radius fractures were induced, manually reduced and internally fixated with a 2.4 distal radius locking compression plate. 2D (anterior-posterior and lateral) and 3D (rotational) fluoroscopic images were taken as well as computed tomographies. Fluoroscopic images, Cone Beam CT (CBCT), 360° rotating sequences (so called “Movies”) and CT scans were co-evaluated by a specialist orthopedic surgeon and a specialist radiologist regarding quality of fracture reduction, position of plate, position of the three distal locking screws and position of the three diaphyseal screws. In reference to gold standard CT, sensitivity and specifity were analyzed. Results “Movie” showed highest sensitivity for detection of insufficient fracture reduction (88%). Sensitivity for detection of incorrect position of plate was 100% for CBCT and 90% for “Movie.” For intraarticular position of screws, 2D fluoroscopy and CBCT showed highest sensitivity and specifity (100 and 91%, respectively). Regarding detection of only marginal intraarticular position of screws, sensitivity and specifity of 2D fluoroscopy reached 100% (CBCT: 100 and 83%). “Movie” showed highest sensitivity for detection of overlapping position of screws (100%). When it comes to specifity, CBCT achieved 100%. Regarding detection of only marginal overlapping position of screws, 2D fluoroscopy and “Movie” showed highest sensitivity (100%). CBCT achieved highest specifity (100%). Conclusion As for assessment of quality of fracture reduction and detection of incorrect position of plate as well as overlapping position of the three diaphyseal screws CBCT and “Movie” are comparable to CT – especially when combined. Particularly sensitivity is high compared to standard 2D fluoroscopy.

scholarly journals Using self-drilling screws in volar plate osteosynthesis for distal radius fractures: a feasibility study

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Alexaner Synek ◽  
Lars Borgmann ◽  
Hannes Traxler ◽  
Wolfgang Huf ◽  
Ekkehard Euler ◽  
...  
Keyword(s):  
Distal Radius ◽  
Feasibility Study ◽  
Plate Osteosynthesis ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Volar Plate Osteosynthesis

scholarly journals Quality of life after volar locked plating: a 10-year follow-up study of patients with intra-articular distal radius fractures

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Paul Ruckenstuhl ◽  
Gerwin A Bernhardt ◽  
Patrick Sadoghi ◽  
Mathias Glehr ◽  
Lukas A Holzer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Locked Plating ◽  
Follow Up Study

Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

2017 ◽  
Vol 43 (2) ◽  
pp. 142-147 ◽  
Author(s):  
Daniel Martinez-Mendez ◽  
Alejandro Lizaur-Utrilla ◽  
Joaquin de-Juan-Herrero
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Distal Radius ◽  
Articular Surface ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Loss Of Reduction

We compared outcomes in elderly patients with intra-articular distal radius fractures treated by closed reduction and plaster immobilization or open reduction and internal fixation with a volar plate. Ninety-seven patients older than 60 years were randomly allocated to conservative (47 patients) or surgical (50 patients) treatment. Over a 2-year period, we assessed patient-rated wrist evaluation score, DASH (disability arm, shoulder and hand) questionnaire, pain, wrist range of motion, grip strength, and radiological parameters. The functional outcomes and quality of life were significantly better after volar plating fixation compared with conservative treatment. We found that restoration of the articular surface, radial inclination, and ulnar variance affected the outcomes, but the articular step-off did not. Twenty-five per cent of the patients with conservative treatment had secondary loss of reduction. We conclude that surgical plating leads to better outcomes than conservative treatment for elderly patients with intra-articular distal radius fractures. Level of evidence: I

CLINICAL APPLICATION OF DOUBLE DORSAL PLATES FOR THE DISTAL RADIUS FRACTURES

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 213-224
Author(s):  
Noriyuki Yoshida ◽  
Kazuhiko Matsushita ◽  
Takeshi Arai ◽  
Ko Izumiyama ◽  
Moroe Beppu ◽  
...  
Keyword(s):  
Cortical Bone ◽  
Clinical Application ◽  
Distal Radius ◽  
Three Dimensional ◽  
Clinical Results ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radial Margin ◽  
Dimensional Models ◽  
Three Dimensional Models

The purpose of this study was to develop plates that fit the contour of the distal radius of the Japanese and can be inserted less invasively. Three-dimensional models of 36 radii of 18 volunteers were prepared. Using these models, the shape of the cortical bone on the radial margin of the distal radius and just below the dorsal fourth compartment of the wrist, to which the plates were expected to be applied, was measured, and the curves of the plates were determined. The functions of approximated curves of the plates were: [ y = -2 × 10-8 x 5 - 2 × 10-6 x 4 + 0.0006 x 3 - 0.0312 x 2 + 0.3274 x + 15.224 on the radial margin of the distal radius and [ y = 7 × 10-7 x 5 - 0.0001 x 4 + 0.0078 x 3 - 0.2355 x 2 + 3.1815 x - 5.6383 just below the fourth compartment. The clinical results of the application of double dorsal plates were satisfactory in clinical cases for the distal radius fractures.

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