Arch Hand Microsurg.  2019 Dec;24(4):294-302. 10.12790/ahm.2019.24.4.294.

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

• Hur J
• Lee BG
• Choi S
• Lee KH

• KMID: 2464464
• DOI: http://doi.org/10.12790/ahm.2019.24.4.294

Abstract

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.

Keyword

Radius fractures; Bone plates; Bone screws

MeSH Terms

Bone Plates
Bone Screws
Female
Humans
Linear Models
Male
Radius Fractures*
Radius*
Tendons

Figure

• 

  Fig. 1 The dorsal cortex of distal radius was divided into four groups by the extensor compartment and Lister's tubercle (1: second extensor compartment, 2: Lister's tubercle, 3: third extensor compartment, 4: fourth extensor compartment, A: extensor carpi radialis longus, B: extensor carpi radialis brevis, C: extensor pollics longus, D: extensor digitorum communis).

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  Fig. 2 The hole after removal of distal screws in three-dimensional reconstructed image defining dorsal cortical screw penetration.

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  Fig. 3 The length between volar cortex and dorsal cortex, which is the extension of screw traces of distal screw in sagittal image, were defined as the appropriate length of screw.

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  Fig. 4 The anatomical index for predicting appropriate length of screw. (A) The anteroposterior diameter of in shaft of radius at level of oblong hole. (B) The lunate depth in sagittal image.

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