A Prospective Cohort Study on Accuracy of Dorsal Tangential Views to Avoid Screw Penetration With Volar Plating of Distal Radius Fractures.

Objective: To assess diagnostic performance of dorsal tangential views (DTVs) to detect dorsal screw protrusion in clinical practice.

Design: Prospective cohort study.

Setting: Level-1 trauma center.

Diagnosis of dorsal screw penetration after volar plating of a distal radial fracture.

Aims: The aim of this study was to investigate whether intraoperative 3D fluoroscopic imaging outperforms dorsal tangential views in the detection of dorsal cortex screw penetration after volar plating of an intra-articular distal radial fracture, as identified on postoperative CT imaging.

Methods: A total of 165 prospectively enrolled patients who underwent volar plating for an intra-articular distal radial fracture were retrospectively evaluated to study three intraoperative imaging protocols: 1) standard 2D fluoroscopic imaging with anteroposterior (AP) and elevated lateral images (n = 55); 2) 2D fluoroscopic imaging with AP, lateral, and dorsal tangential views images (n = 50); and 3) 3D fluoroscopy (n = 60). Multiplanar reconstructions of postoperative CT scans served as the reference standard.

Interpretations of the Term "Watershed Line" Used as Reference for Volar Plating.

 The objective of this systematic review is to provide an overview of all interpretations of the definition of the watershed line used in literature.  The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed for this review. A comprehensive search was performed for definitions of the watershed line given in literature.

Influence of training on dorsal tangential radiographic view to detect screw protrusion after anterior plating of the distal radius: a cadaveric study.

In this cadaveric study of anterior plating of the distal radius, we aimed to determine the interobserver agreement and diagnostic performance for detecting dorsally protruding screws using the dorsal tangential radiographic view before and after specific training. Without prior instruction, 13 observers interpreted the dorsal tangential view of cadaveric specimens, in which anterior radial plates were placed. After seeing a training video on the dorsal tangential view, they repeated the task.

The Watershed Line of the Distal Radius: Cadaveric and Imaging Study of Anatomical Landmarks.

 Placement of volar plates remains a challenge as the watershed line may not be an easy-identifiable distinct line intraoperatively.  The main objective of this article is to define how anatomical landmarks identifiable upon the volar surgical approach to the distal radius relate to the watershed line.  We identified anatomical landmarks macroscopically upon standard volar approach to the distal radius in 10 cadaveric forearms and marked these with radiostereometric analysis (RSA) beads in cadaveric wrists.

Volar Plating: Imaging Modalities for the Detection of Screw Penetration.

 Volar plating for distal radius fractures exposes the risk of extensor tendon rupture, mechanical problems, and osteoarthritis due to protruding screws.  The purpose of this review was to identify the best intraoperative diagnostic imaging modality to identify dorsal and intra-articular protruding screws in volar plating for distal radius fractures.  The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed for this review.

MRI Study on the Distance between the Distal Radius and the Flexor and Extensor Tendons: Is There Any Room for Error/Hardware?

 This study aims to quantify the distances between the cortex of the distal radius and flexor and extensor tendons.  We analyzed 50 magnetic resonance images (MRI) of intact wrist without pathology. The distances between the volar cortex and the flexor pollicis longs (FPL), index flexor digitorum profunduns (FDPi), flexor digitorum profundus (FDP), and flexor digitorum superficialis (FDS) were measured at the level of the watershed line and 3- and 6-mm proximal to this level.

Distal Radius Volar Plate Design and Volar Prominence to the Watershed Line in Clinical Practice: Comparison of Soong Grading of 2 Common Plates in 400 Patients.

Purpose: To compare plate positioning in clinical practice of 2 commonly used volar locking plate designs with respect to the watershed line as classified by the Soong grading system.

Methods: For this retrospective study, we included a total of 400 patients who underwent open reduction and internal fixation between May 2013 and February 2018. Cohort 1 was defined as patients treated with distal volar radius (DVR) plates during this period.

Volar plating in distal radius fractures: A prospective clinical study on efficacy of dorsal tangential views to avoid screw penetration.

Purpose: The purpose of this prospective cohort study of patients treated with volar plating for distal radius fractures is to evaluate the efficacy (defined as detection rate, or the ability to detect dorsally protruding screws) of additional dorsal tangential views (DTV) after obtaining standard anteroposterior (AP) and elevated lateral views by evaluating the change in intraoperative strategy in 100 patients.

Materials And Methods: 100 patients aged 18 years and older undergoing volar plating for acute extra- or intra- articular distal radius fractures were prospectively enrolled. Intraoperative fluoroscopy views, including AP, elevated lateral and DTV were obtained.