Is it possible to avoid intra-articular screw penetration with minimal use of fluoroscopy in the application of distal radius volar plate?

Objectives: This study aims to investigate whether or not it is possible to avoid intra-articular screw penetration in the application of distal radius volar plate with minimal use of fluoroscopy and thereby reduce to a minimum the risk of exposure of the surgical team to radiation.

Patients And Methods: Volar plate with distal screw application with minimal use of fluoroscopy was performed in a total of 50 patients (22 males, 28 females; mean age 43.52 years; range 18 to 76 years) with unstable distal radius fracture following reduction of fracture between June 2014 and May 2016. A specially designed volar anatomic plate was applied by creating a 3 mm gap proximal from the tip of the facet of the lunate fossa.

Results: No intra-articular screw complication was observed during plate-screw applications that we performed by using fluoroscopy at a minimum level and paying attention to the surgical technique described with the plate designed by giving a specific angle to screw beds. During the operation, fluoroscopy was performed at a minimum level and no finding was observed which could suggest use of intra-articular screw. No findings of restriction in wrist movements, locking or friction were observed intra- or postoperatively.

Conclusion: With improvements in the design of the volar plate and the distal locking screw bed, it is possible to rule out the possibility of intra-articular screw complications and the need for surgical re-correction in the early-term, and to reduce to a minimum the risk of exposure of the surgical team to radiation.